LETTER TO THE EDITOR: Debate is a good thing for elected offices

In July, 1988, the late Dr. Jack Turner, Roger Sanderson, and I were asked by the Ector County Commissioners Court to serve on the Board of Medical Center Hospital (MCH). The hospital was in crisis; the hospital’s bank account was overdrawn by more than $3 million. During the subsequent 18 months, the board would face three major issues, none of which was resolved by unanimous vote.
The first major decision was considered in August, 1988 when the management contract of Hospital Corporation of America (HCA) came up for renewal. HCA had managed the hospital for more than 15 years, but HCA offered no cohesive plan to improve the hospital’s financial condition. After a somewhat contentious board debate in open session, the vote was 5-2 to end the management relationship with HCA.
The board then hired Tom Pace as the interim administrator giving the board time to interview candidates. The citizens of Ector County owe Mr. Pace a debt of gratitude for stepping in when needed. After a series of interviews, the board hired Mike Stephans, and the turn-a-round of MCH gathered momentum. Dr. Turner stepped aside for health reasons, and the late Dr. C. S. Patterson stepped up to fill his position.
When MCH ended FY 1988 with a bank overdraft of $3,426,288, Mr. Stephans created the operational plan necessary to improve the MCH financial condition. His plan called for such difficult decisions as layoffs, pay cuts, and cancellation of capital projects such as a signed contract for a parking garage. These painful recommendations were endorsed by the board. Strategically, a majority of the board realized that the only way to insure the future of MCH was to create a hospital district.
This second major decision was discussed by the board many times in open session. Public forums were held; sometimes the debate got heated. Regardless, the issue was finally approved by a majority of the board and delivered to the voters of Ector County at an election held in November, 1989. The hospital district issue passed, with an approval of about 55% on a relatively large turnout.
A newly appointed board was then charged with oversight of MCH until such time as a public election could be held to select new members. Mr. Sanderson and I were asked to continue on this appointed board.
The third major decision was to consider a sales tax for support of MCH. Some appointed board members thought this decision was best left to a publicly elected board. Others thought that new monies created by a county wide sales tax were essential to the future of MCH. Even with the many difficult operational measures previously implemented, MCH closed FY1989 with smaller, but still significant, overdraft of $242,039. After full debate in open session, a majority of the board voted to pursue the sales tax. Legislation was drafted, and the vote on the sales tax issue was scheduled for May, 1990, the same date as the first election of MCH board members. The sales tax passed by a margin exceeding 70%, again, on a large voter turnout.
As proven by these three issues, a unified board is not necessary to insure that progress is achieved. Constructive argument is necessary to fully explore any issue, particularly those complex problems that are encountered in healthcare.
The key is for the debate to be issue driven, for arguments to be supported by solid analysis, and for the debate and analysis to be made available to the public in full disclosure.
The current board of MCH would be well served to consider these key elements of constructive argument.