I support the privatization of many government services; I wrote an entire paper on it. I know you’ve all read that paper several times, but here’s the link if you need a refresher.
In many cases, privatizing services—either by sale, contracting, or other options—can lead to better service at lower costs for taxpayers and residents. Privatization is, in short, a good thing.
But it has to be done right. It has to be done as part of an open and transparent process. In Perry County, an attempt to privatize the local county hospital is not being handled properly.
But let’s step back, because the further back you go the worse it gets. In the 1990s, control of Perry County Memorial Hospital (PCMH) was passed from the elected, county hospital board to a private board. I was informed this was done behind the scenes and under the cover of night, like when the Colts left Baltimore. I’m further told everyone involved in that decision is gone now (i.e. dead), so who knows how or why it happened. Perry County still owns the physical hospital itself, but that is all.
Now, that private board is leading the effort to turn over management of PCMH over to Mercy health systems. There has been basically zero public input on this decision. Some community leaders scheduled a public forum on the issue, and nobody from the private board attended. A letter released by community leaders after that meeting stated:
This decision is being made by a small group of people in private meetings. This lack of transparency and secret maneuvering calls for your immediate attention as the PCMH private board has historically acted without transparency. The community’s citizens have a right to information that directly affects their access to health care.
Outsourcing the operations of PCMH to Mercy may be a great move. Heck, it probably is a great move. The economics of small, publicly operated hospitals are hard and getting worse. But that doesn’t mean that an unelected board gets to make these decisions behind closed doors without public input.
I fear the private board will frame its final plan to the county commission as a fait accompli with an implied threat to do something drastic if the county commission does not approve it. Possibilities there could include large cuts to hospital services, shutting down PCMH entirely, or hiring Joe Exotic to turn it into a big cat animal sanctuary. (Okay, probably not the latter.)
This process is bad public policy and bad for democracy. If the Mercy plan is good for the community, make the arguments in public and do the hard work required to convince the people of Perry County. After all, it’s still their hospital, even if just barely.
