First a punt, now a turnover

Latest hospital decision in county's hands goes to the state

Call it the vote that wasn’t.

The Columbia County Commission couldn’t manage to choose a favorite among three health systems vying to build the county’s first hospital. That essentially hands the decision over to state regulators without any endorsement from the very community the facility would serve.

The county’s quest for a 100-plus-bed hospital is the biggest economic development game it has ever played, and Tuesday’s decision amounted to a turnover.

An equal endorsement is the same as no endorsement, which is another way of telling the Georgia Department of Community Health – the final arbiter in the decision – that whichever hospital it chooses is just dandy with Columbia County.

The political pressure apparently was too much for commissioners to handle, as was the case last month with the commission-appointed citizens hospital advisory committee, which also failed to make an endorsement.

Choosing one of the three competing systems – Doctors Hospital, Georgia Regents Health System and University Hospital – would have put county leaders at odds with constituents favoring the other two. And with county elections less than two months away, that is a risk Commission Chairman Ron Cross apparently was loath to make.

We’ve come to expect our national leaders to shirk tough decisions, but shouldn’t we expect a little more from the elected officials who actually share our ZIP codes?

Yes, the decision was politically convenient, and it may also prove to be legally prudent, given that the state’s archaic and complicated Certificate of Need program criteria. The state, which says Columbia County is already adequately served by Richmond County facilities, and would allow a new facility in the county only if it falls under one of three exceptions. Each competing health system claims it meets one or more exceptions, but legal challenges are almost assured for any system that secures a CON.

State health officials were never bound to follow any county-level decision, but what is the harm in letting state officials know the community has a preferred choice among the three possible dance partners?

An unsettling prospect is that the commission, contrary to the statements of its members, does in fact have a preferred health system in mind. Might commission members avoid election-year fallout by lobbying state regulators behind the scenes on behalf of that provider? If so, what political cowardice.

Of course, all this hand-wringing would be unnecessary if the CON process was repealed. Instead of rightly letting the free market determine a hospital’s viability, the CON approach essentially grants a health system monopoly status in a community.

But since the state is saddled with the CON system, a county government should take advantage of the fact that local preference is a significant factor in the CON decision-making process. To not flex that political muscle is an abrogation of duty.

Columbia County residents apparently will have to wait for bureaucrats in Atlanta to decide which health care provider – if any – will be best for them.

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