Letter to the Editor

The case for the hospital tax

Monday, September 29, 2014

To the editor:

I am not a member of the Hospital Board, nor do I have any financial connection to the Hospital System. I do have a personal connection with the hospital system, though -- the hospital put a roof over my head as a child. When my father retired from the Air Force in 1969, he became laboratory director for what was then Chickasawba Hospital and worked there until he retired. My mother went to work for the Hospital System in the late 1970s and ran the gift shop until she retired. I even worked there once summer in high school over 30 years ago; it was the hard labor on hot summer days keeping the hospital grounds that convinced a 16-year-old boy that going to college might be a smart move. My point in saying all of this is that, like the 349 people who work there today, I have a very personal understanding of what the hospital system means to the life of our community.

The proposed tax to be voted upon Oct. 14 is a half-cent county sales tax with a five-year sunset with resulting tax revenues devoted to our local Mississippi County Hospital System. Of the anticipated $12 million of tax revenue over the five-year period, $5 million will be used to purchase needed new medical equipment, $2 million will be used for physician recruitment (including new general practitioners in both Blytheville and Osceola), and $2 million is designated as a contingency fund to absorb expected reductions in federal reimbursement rates to rural hospitals as a direct result of the Affordable Care Act, more commonly known as Obamacare. The exact percentages of reimbursement reductions are not yet known because the federal government has still not yet determined all of the costs involved with implementing Obamacare. The remaining $3 million of anticipated tax revenues will be spent on extending the life of our existing hospital facilities through building repair and renovation. Among the many reasons that I am voting for the tax are the following critical issues:

-- The existence of local hospital services is absolutely essential to retaining existing industries and attracting new industrial growth. For several reasons, with workers' compensation insurance costs foremost among them, large employers will not consider communities without local hospital services because it is simply cheaper for them to do business in communities that do provide such services. Show me a county that has lost its hospital system and I will show you a county with no significant economic development, severely depressed property values, and little hope for the future.

-- Supporting and strengthening our hospital system will mean retaining one of our county's largest employers. The Mississippi County Hospital System employs 349 people, the vast majority of whom live in Mississippi County, with an annual payroll of $15 million. The loss of such a crucial job source would have an immediate, devastating effect on our local economy and home values.

-- Proposals to build new facilities are simply far too expensive and impractical. A common misconception that seems to exist is that all of the proceeds of the proposed tax would be spent on the existing hospital facilities. As detailed in my first paragraph, only $3 million of the anticipated $12 million would be spent on the existing facilities. The remaining $9 million would have to be expended regardless of what type of facility we had. Any proposal for new facilities, whether that be one or two small, emergency type facilities or one large facility built at the Interstate, would require at least twice as high of a tax (a full cent) for at least twice as long a period of time (10-15 years instead of five years). No such facility -- one or two, large or small -- could be built for any amount anywhere near $3 million. Realistically, building one new full-service hospital likely could not be accomplished with a sales tax because of a price tag of $40-50 million; a property tax millage, likely permanent, would be needed. The current proposal put forward by the Mississippi County Hospital Board is, by far, the most cost-effective and least burdensome for the citizens of the County.

-- Suggestions to close one of the two hospitals are uninformed and unworkable financially. The Osceola hospital has a special critical care access designation that provides higher reimbursement rates from the federal government that most hospitals, including the Blytheville hospital, do not possess. For this reason, the Mississippi County Hospital System charges every possible system expense to the Osceola hospital to obtain the highest possible reimbursement rate to allow the system to be viable. This critical care access destination is specific to the existing land site of the Osceola hospital; it is not transferrable across the street, much less 20 miles north to Blytheville. Consequently, if the Osceola hospital closes, the Blytheville hospital cannot cover its expenses. Similarly, the Osceola hospital is not economically viable as a stand-alone facility because the additional, higher volume of business provided by the Blytheville hospital is needed to survive. The bottom line is that the two hospitals have to have each other in the current arrangement in order to be viable. Close one, you close both in a short period of time.

-- Access to 24/7 medical care and common specialty services is a vital element of a community's quality of life. For example, I have undergone three special X-ray procedures in the past two months, all at our local hospitals. Without our hospitals, I would have had to take off work and drive to Jonesboro. For me, as a college president privileged to have professional staff to cover for me, this would not be much more than an inconvenient hassle and added expense. But what about all of the people who do not have such flexibility with their jobs? What about the poor and elderly who may not have easy access to transportation an hour away? Many of these situations would result in people living through pain and suffering due to lack of accessible treatment.

I urge every citizen of Mississippi County to go to the polls and vote Yes for the hospital tax on October 14 and preserve a positive future for our county.

Dr. James R. Shemwell
Mississippi County