Similarly, it would be unconscionable (and illegal!) for the proposed SHH to deny services to non-residents of the service (and taxed) area. Therefore the hospital would not be able to restrict its services to only those who are paying the Health District tax, and it would be illegal to charge more to "out of the district" patients; so an additional unjust financial burden would devolve on those taxpayers who are paying for the hospital, while non-taxed residents of Columbia County enjoyed our largesse.

LEGACY'S ATTITUDE TOWARDS THE "MEDICALLY INDIGENT"

Lawsuits have recently been filed against two Portland area not-for profit hospital systems, each charged with being a very profitable enterprise and whose CEOs reportedly each earned $1.4 million annual salaries. 

One of those, the Sisters of Providence, had earnings of some $1.4 Billion and gave only $56 million (about 5%) in "charity" care. The other, Legacy Systems, having revenues of some $700 million also is charged with providing an insufficient level of charity care to those unable to pay.

Legacy is the System that has been selected to operate the proposed hospital in St. Helens; their business practices with respect to the medically indigent have already been established by history.

PUBLIC MONEY IS NOT "FREE" MONEY

While the budget and rate regulatory programs are virtually gone and the Certificate of Need program is much reduced in scope, there is still a political, moral, ethical and good business judgment requirement for properly and carefully considering expenditures of large sums of public money to provide services to the general public.

Virtually all of the capital funds and a large part of the operating funds for the proposed hospital will come from taxation sources, especially special property tax levies, grants and low interest loans from either the State or Federal governments. Ultimately, the source of that money is always the taxpayer.  It is NEVER "free" money.

THE HOSPITAL'S FINANCIAL WELL-BEING

Because, in my opinion the proposal will fail on many counts, to obtain a C/N I did not take the considerable amount of time needed to do a comprehensive analysis of the financial data. I looked only at certain financial aspects relative to previous comments, but a substantially more detailed and critical analysis should be done.

The rationale and data used in the Study that I reviewed are highly suspect. Data from the State of Washington hospitals are used without explanation as to why, when perfectly valid data are available from Oregon agencies and payors. As only one small example, though perhaps indicative of wider application, the Study, on page 19, paragraph C, states that a 2002 scanning charge of $950 was used to calculate that for 2007. The escalation rate was stated to be 3% annually.

The average scan charge in 2004 is only $500 and at the 3% compounded annual increase, would reach only $546 in 2007, yet the entry on Table 17 (also on page 19) shows the per scan rate to be $1101. This is a significant error, (a 102% overstatement of income) perhaps placing all the financial pro-forma projections in dispute. Similarly, the $524 per Emergency Room visit in 2007 appears to be an understatement, when compared with Oregon's 2004 average of $490 per visit, rising to $535 in 2007 (using the same inflation assumptions.)

I also note that the rate of CT scans is projected to be 1 in every 6 visits; that appears to be a significantly high rate. Perhaps the scans are going to be given simply to justify (and pay for!) the existence of the scanner and its operator.

I seriously question the consultant's statement claiming "…a critical access hospital in St. Helens could start to turn a profit in as little as two years."

Unless the facility was built and staffed without cost to either the facility or the Hospital District and its daily operational expenses were totally paid for by third-party reimbursers, I simply cannot conceive of how any 15 bed unit could financially survive, let alone create a profit, in 2 - or perhaps, 5 or more years. That consultant's finding appears to be totally contrary to logic. Certainly Medicare, Medicaid, the Oregon Health Plan or any of the other Insurance Companies' policies would not permit the capital costs to be fully amortized and reimbursed by them in two years. Nor would the $100,000 - $150,000 per year salary of an M.D. plus their profes