Caution: ‘Big government’ at work


Well, that didn’t take long.

As I suspected, the rural health care district (RCHD) board made its move, following the commissioners’ vote a few weeks back not to give permission to build the critical access hospital (CAH) or deed the land to the district.

At yet another special meeting last Wednesday (followed by another special meeting Thursday), the board voted to solidify its relationship with St. John’s Medical Center in Jackson. This is troubling news on a number of fronts – and it has nothing to do with the CAH.

For starters, the public was kept in the dark about the whole darn thing. This, in itself, is a serious problem. We’re not talking about a private hospital making business decisions behind closed doors here. We’re talking about a public entity – a taxpayer-funded entity – making a serious decision on the future of health care without an ounce of public input.

What’s more, the public was not even allowed to speak on the issue until after the 3-2 vote had taken place. In other words, not a single member of the public was allowed to voice an opinion on the future of health care in Sublette County until the matter had already been decided.

Frankly, it reminds me of the complaints so often levied against the nanny state of “big government,” which always knows what’s best for its citizens – input not needed. The citizenry had not a single say in this vote to pony up with St. John’s.

I was told by a board member that one of the reasons it was kept quiet is because the legal counsel of St. John’s – a private hospital, mind you – did not want it publicized until the deal was done.

That’s all good and well for a nonprofit hospital. It’s a private-sector business that’s not beholden to the same open-meeting rules and transparency-related regulations of the government sector. The RHCD, however, should know better. In fact, they should WANT better.

But no – instead, they followed the lead of St. John’s lawyers and kept the public in the dark.

My greatest fear in this whole deal is that local control will ultimately be relinquished. It seems the board’s secret dealings that led to Wednesday’s vote could very well be a dangerous indicator of things to come. Is this the first domino on the slippery slope to relinquishing the reins? If they were unwilling to publicize such a monumental decision based on the advise of legal counsel from a private organization, what else is in store?

From the health care district’s perspective, I can’t, for the life of me, figure out what benefit the district had by keeping it in the dark – unless, of course, I include the political posturing that seems to plague our county’s elected. Either way, last Wednesday’s vote was an utter disservice to the Sublette County residents.

No question, this deal has been in the works for some time. Clearly, this was the “other avenues available” that board chair Laura Clark was referring to when the commissioners asked what could happen if the commissioners opted not to take a vote the other week.

Blending a public entity with a private entity is muddying dangerous waters, and we can already see it in play with the recent changes at the top of the RHCD. Am I too cynical for my own good to think that Malenda Hoelscher’s move to St. John’s is somehow related to this whole thing? In fact, at this very moment, she’s working for – and getting paid by – both organizations! Did she grease the wheels on this arrangement? Am I the only one who’s more than a little uncomfortable with her dual roles? But hey, at least she’ll get those retirement benefits.

This whole thing begs the question: What else is happening behind the veil of secrecy at the health district? As a journalist, a healthy dose of skepticism is part of the job description. But in this case, my skepticism is growing unhealthy. The whole thing reeks of back-door deals and under-the-table arrangements.

And let’s not forget the stellar reputation of sound financial management at the district. We have more examples to add to that reputation in recent weeks.

In case you missed it, the district was patting itself on the back at its regular meeting the other week for saving $740,000 this fiscal year – a year that included the closure of the after-hours care in Marbleton and Saturday hours at both clinics. Because of those savings, the board voted to give everybody (except providers) at the district a 5-percent bonus. Despite protest from some board members, they opted to included Hoelscher and Lorraine Gatzke in the raises – thereby flushing $14,000 down the toilet on those two execs alone.

Now I fully understand the argument to give the “grunt workers” a raise, regardless of whether it’s a winning argument or not. But to even include the top administrators in that conversation is downright ludicrous – and a testament to the reputation the district has earned over the years. In case you forgot, this is the same group that went to the municipalities and the county over the past year or so begging for money to help construct the CAH. But yeah, sure, they have plenty of money to spend on bonuses.

Then there’s the CAH. The vote to go find their own land and build their own building is going to skyrocket costs, and early estimates put the new and improved price tag at TWO to THREE TIMES the cost than if the RHCD played nice with the county and found a solution.

Board member Wendy Boman tried to table the vote to join St. John’s by one month. She’s been meeting individually with commissioners and making some progress. The old guard on the board, however, did not agree.

Really? What’s another month when you’ve already waited 33-plus months? … especially when that month could potentially save the district – er, I mean, the taxpayers – millions. Yet this board still insists that the days of financial squandering are in the rearview mirror.

The RHCD is not normally one of my beats, but by nature of CAH coverage and the role of the commissioners, I’ve been getting a much closer look at the RHCD’s dealings. And I have to say, every time the magnification is turned up on the microscope, I’m finding more trouble.

Then again, the press release we got from the district last week insists that everything is wonderful … full-steam ahead … the future of health care in Sublette County is bright … worry not, dear citizens, we’re got it all under control … sit back and enjoy the ride.

Aaahh, the reassuring and soothing sounds of big government: “We know what’s best for you. Public scrutiny not needed.”

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