MetroHealth welcomes debate on ongoing efforts to update Ohio’s antiquated county hospital laws: Thomas M. McDonald and Vanessa L. Whiting (Opinion)

September 5, 2018

MetroHealth welcomes debate on ongoing efforts to update Ohio’s antiquated county hospital laws: Thomas M. McDonald and Vanessa L. Whiting (Opinion)

CLEVELAND -- In regard to Friday’s editorial, “MetroHealth expansion outside Cuyahoga County should have involved public debate,” MetroHealth is always eager to play a role in thoughtful and transparent conversation, especially when it involves the care of Ohio’s most vulnerable residents.

Passage of House Bill 111 allows MetroHealth to respond to the health care needs of surrounding communities and to provide crucial care for patients in eight additional Northeast Ohio counties. MetroHealth’s mission compels us to provide care to those in need, whenever we can, wherever they are. And we’ve lived by that principle for the past 181 years, caring for those with cholera, tuberculosis, polio and HIV. It’s why we volunteered to serve as the Ebola Center for the entire state of Ohio.

The bill made a small but significant change in Chapter 339 of the Ohio Revised Code, the section of state law that governs county hospitals. To call ORC 339 antiquated is an understatement. Most of its current provisions date back to a 1908 act that established the framework for Ohio’s county hospitals. The last time a major provision was added to ORC 339 was in 1953.

Imagine for a moment if the rules governing Ohio’s banks, building codes or boards of elections hadn’t been significantly updated since the Eisenhower administration.

It’s no surprise to learn that more than 70 percent of Ohio’s county hospitals have either closed or been consolidated into other health systems. Since 1995, at least nine county hospitals in Ohio have closed or converted to nonprofit status.

MetroHealth is unique among the survivors. It is the only Ohio county hospital serving a large urban area – providing safety-net care to more than 100,000 of the most vulnerable members of our community. In terms of patient visits, it provides 1.4 million per year, more than 20 times that of the second-largest county hospital.

Moreover, we work to improve the health of everyone in the communities in which we are located, not just the patients who walk through our doors. As a county hospital, that’s what makes us special. According to America’s Essential Hospitals, more than a third of all Level I trauma centers and burn care beds are operated by hospitals like MetroHealth. 

Nationally, health care is experiencing rapid-fire integration that is reshaping the business of managing hospitals and health systems.

Public hospitals are a threatened species – on their way to becoming endangered. State, county and city hospitals are closing at a rate 11 times that of other hospitals.

Since 1976, America has lost almost half its public hospitals, more than 800, even as our nation’s population has increased by more than 110 million. During the first half of 2018 alone, Ohio saw three hospitals close their doors.

Again, MetroHealth is a special case. Our system is thriving, and as a result, we are providing more care and services than ever before to our neighbors on Medicaid and those who are uninsured. Last year, we spent $160 million providing free care and covering costs not paid by Medicaid. Thanks to House Bill 111, we may be able to expand our care and mission to more Ohioans in need.

As the current and future chairs of MetroHealth’s Board of Trustees, we have encouraged the health system’s leadership to begin working with lawmakers to modernize ORC 339.

MetroHealth is not asking for special treatment or a competitive advantage, only for more up-to-date rules on how we operate. The goal is to ensure that Northeast Ohio’s essential health system is here and healthy for our children and grandchildren.

As thoughtful and open debate on modernizing ORC 339 begins locally and in Columbus, MetroHealth hopes that all those joining the conversation are guided not by competition or profits but by what matters most – the health and care of everyone in Ohio. 

Thomas M. McDonald is chair of the MetroHealth System Board of Trustees. Vanessa L. Whiting is the board’s chair-elect. 


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