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Navarre opposes surgery center, calls for CPH support

Posted: January 24, 2012 - 4:32pm  |  Updated: January 24, 2012 - 4:42pm

Kenai Peninsula Borough Mayor Mike Navarre said Tuesday he was “hopeful” the state would reject the Certificate of Need application from a group of local surgeons looking to build a surgery center in Kenai.

At a joint Kenai and Soldotna Chambers of Commerce luncheon, Navarre spoke about the health care industry in general and touched on Kahtnu Ventures’ proposal to build a $9 million, 8,365 square foot building to perform an estimated 1,700 outpatient surgeries a year. The proposal is currently being considered by the state after public comment closed Monday.

“I am hopeful the Certificate of Need will not be approved and that the center will not be built,” Navarre said. “That is what I feel is best for our community and for the borough. I think that is a result of the fact that we own two hospitals.”

Navarre said the action of the Kenai Peninsula Borough Assembly to formally oppose the center was “proper” and “responsible” and also praised the Soldotna City Council for also opposing the need for such a center.

“I don’t think it is needed at this time in terms of capacity,” he said. “And secondly, I think that if there is a need, and at some point in the future there will be a need, I think that facility should be owned by the hospital, should be operated by the hospital and the proceeds from an outpatient surgery center should be used to benefit the citizens of this community. There are already enough profit centers in health care.”

During his speech, Navarre also called for residents to support Central Peninsula Hospital, whose officials are fighting the proposal on the grounds the surgery center would take away one of the more lucrative service lines it offers, thus damaging their less profitable areas and the non-profit hospital overall.

“Central Peninsula Hospital needs your support,” Navarre said. “It needs to be consistent and it needs to be sustained and it needs to be unwavering ... to make sure that we provide the benefit and use our community asset — the hospital — to the best benefit of all of our citizens.”

Navarre also speculated on if and how the community would view the project differently if proposed by an outside group.

“I think that most of you would probably agree that yes, we would (view it differently),” he said.

However, what’s most important, the mayor said, is what happens after the state’s decision.

“We will either have an outpatient surgery center that is built and deal with those associated impacts or we will not have one and we will still, as a community, have a little bit of dissention between the hospital currently and some of those in our medical community and we need to try and bridge that gap,” he said. “We need to try and figure out how we move forward as best we can from a consensus standpoint.”

Karen Lawfer, Certificate of Need coordinator for the Alaska Department of Health and Social Services, couldn’t give specifics on the number of comments she received regarding Kahtnu’s proposal.

But it is “a lot,” she said.

“I have never received as many comments,” said Lawfer, who has been in her position for five years.

According to state information, a staff analysis of the application and recommendation must be submitted to the commissioner of the Division of Health Care Services by Feb. 19 unless additional time, not to exceed 30 days, is granted by the commissioner.

A decision by the commissioner must be made within 45 days of receipt of the staff recommendation unless additional public notice is given that additional information or analysis is required by the commissioner to make a decision.

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akmscott
131
Points
akmscott 01/24/12 - 05:36 pm
0
0
A simple case of protecting

A simple case of protecting the status quo-and protecting powerful saleries

Carver
1118
Points
Carver 01/24/12 - 05:38 pm
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Opposing public opinion?

At this point, the Clarion's public opinion poll is running nearly two-to-one IN FAVOR of the proposed surgery center.

The borough assembly's vote also opposed the majority of public opinion as shown in the Clarion's poll.

Oh, well . . .

Norseman
3202
Points
Norseman 01/25/12 - 09:10 am
0
0
get your facts straight

carver, get your facts straight. The vast majority of tax payers are on the same side of this issue as the assembly is.

It doesn't take a whole of business savvy to realize just what would happen to our hospital if this is allowed.

Carver
1118
Points
Carver 01/25/12 - 10:14 am
0
0
Don't think so . . .

carver, get your facts straight. The vast majority of tax payers are on the same side of this issue as the assembly is.
*******************

Thanks for your opinion, Norseman, but I don't think so. If you would take a quick peek at the Clarion's online poll of this very minute, you'll see that your "vast majority of tax payers" SUPPORTS the Kahtnu surgery center. Fully 65-percent of those responding to the poll are IN FAVOR of the venture. Only 35-percent "are on the same side of this issue as the assembly is."

No, I'm afraid that the mayor's and the assembly's positions are but one more reflection of the disconnect between average Americans and the people we vote into office.

All we, the public, can do is to note such things and remember them the next time these people come asking for our votes.

In the meantime, CPH will be just fine . . they've money to give away:

"CPGH, Inc. spends $75,000 to $100,000 a year in sponsoring community events and donating to nonprofit organizations, said Tom Boedeker, president of the CPGH, Inc., board of directors. The money comes from hospital operations, not tax dollars, Boedeker said. . ." —RR, June, 2010

CPGH Inc. has forgotten the original mission of CPH as a place for docs to ply their trade. Inc. has maneuvered CPH into competition with independent area docs, and Inc. has maneuvered CPH into a vehicle of patronage to area entities such as the Food Bank, Kenai Watershed Forum, and Kenai River Sportfishing Association.

Norseman
3202
Points
Norseman 01/25/12 - 10:48 am
0
0
source

So you are basing your facts because of a poll on this newspaper?
Man are you out of touch. I suppose you base your other facts based on those who call into sound off also?

Do you pay borough taxes? Are you a homeowner? If you are, then you really need to look at the big picture that has been clearly spelled out by CPGH, our Mayor, and the assembly on what will happen if this business venture is allowed to go through.

When we lose any monies from the hospital, it costs us, the taxpayer. We OWN this hospital. That is those of us who pay taxes. Why on earth would anyone who OWNS a business want to have another source move in and cut into our profits? That is no brainer.

Those who take ownership in our hospital realize this and can see clearly what will happen. Those who do not take ownership of our hospital seriously wish to see it fail.

Economics 101 is at work here. Money and profits.

Carver
1118
Points
Carver 01/25/12 - 11:17 am
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The sky is falling?

Thanks again, Norseman, but the truth is that no one "can see clearly" what will happen should our area surgeons be allowed to build the clinic. The way I hear it, lots of folks leave the area for day-surgery simply because CPH is so expensive. Could be that a new surgery center will pick up that lost business and thereby benefit the area's tax base. Reckon?

But whatever . . no one knows. All we're hearing is doom-and-gloom, the-sky-is-falling prognostications designed to scare us to death.

No, I'm sure Inc. doesn't want what it perceives as competition, but it was Inc. who, after years of working hand-in-glove with our area's independent physicians, first entered into competition with our area docs by hiring their own docs, employed by CPH. What's good for the goose is good for the gander—no?

As for Econ 101, the first premise of free enterprise Capitalism is competition. Can't stand the heat? Stay out of the kitchen.

Norseman
3202
Points
Norseman 01/25/12 - 11:46 am
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0
bingo

You are absolutely correct about free enterprise and competition. That is my point, we cannot afford to be in competition with the proposed surgical center.

Providing health care to a community where the community owns the hospital is much different than home depot vs lowes.

The minute we take this away from our hospital, we the taxpayer, will be making up the difference in lost revenue.

This group of doctors see a huge profit potential. They stand to reap huge profits while us the taxpayer, will be seeing an increase in taxes to make up for the lost revenue. Is that what you want?

Where do you think the hospital will go to make up for the lost revenue? To the tax base is where. The sooner folks wake up and smell the coffee, the sooner they will relalize what will happen.

This isn't reading a fortune cookie, it is reality.

Carver
1118
Points
Carver 01/25/12 - 12:16 pm
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Good discussion . . .

Good discussion, Norseman, let me reply to your points above.

First, yes, the docs see a potential for profit or they wouldn't be contemplating the surgery center. Nothing wrong with that, is there? However, your opinion that the center will necessarily create a burden on the taxpayer is a bridge way too far. Neither you nor I know what will obtain should the surgery center be built.

Second, as for any competition that might ensue, CPGH Inc. should have considered that before they went into competition with independent area docs.by hiring docs to be employed by CPH.

Third, CPH is far from short of funds when they and CPGH Inc. are able to dole out tens of thousands of dollars to area entities. Last I knew, Inc.'s president fished KRSA's Classic last year—who paid for that? Who gave Inc. the authority to become a vehicle of patronage, dispensing at will, the dollars earned by a publicly-owned facility?

Finally, relax, whether or not the CON is granted is up to the state to decide, and I'm pretty sure they have better criteria by which to decide than doom-and-gloom, public opinion. Whichever way it goes, we'll survive just fine. In the end analysis, this is about principle—freedom of choice, free enterprise, and all that.

Norseman
3202
Points
Norseman 01/25/12 - 12:59 pm
0
0
I agree that our hospital is

I agree that our hospital is not perfect.
I also agree the Inc has absolutely NO business giving out money to any organization.
However, this issue is about something that can be predicted fairly accurately.

It does goes against the grain to be against free enterprise. However, this issue is about the long term health of our community and it's citizens.

Whatever the outcome is, I am very grateful to have the quality of physicans we have here.

cbeard
132
Points
cbeard 01/25/12 - 03:51 pm
0
0
Efficiency

I'm very surprised at the rhetoric against potential non-CPGH medical facilities. Everybody should be concerned about CPGH, but more people need to be concerned about quality and access to medical care.

CPGH just needs to deal with the growing pains that thousands of other city's hospitals in the world experiences when they finally realize "Oh shoot, the population is too big and we're not going to be the only kids in town forever".

What's the worst that could happen to them, they'll have to become more efficient, affordable, and do more non-profit work to maintain a competitive quality of service and public relations image? Sounds like a win for CPGH patients to me.

They cite "losing services" as a consequence of the surgical center. That's only a half-truth, as any specialized services lost (doubtful, competitors can't force you to "stop" doing anything) would be found where? The surgical center!

And then there's the rather DANGEROUS rhetoric Navarre states: "I think that facility should be owned by the hospital, should be operated by the hospital and the proceeds from an outpatient surgery center should be used to benefit the citizens of this community. There are already enough profit centers in health care."

So, he thinks the Kenai Peninsula Borough should hand over a monopoly of medical care to the private executives of CPGH just because they're wooed by public outreach projects? Monopolies are wrong and they only lead to declining customer (in this case, patient) satisfaction.

The CPGH is deservedly enjoying its current gravy train because of its outstanding service and progression, however the population is growing regardless, and despite the progression of health care reforms not everybody is caught up to having affordable insurance yet, so there is still plenty of reason for competition.

Consumers deserve choice, not monopolies. Even in countries with socialized health care different institutions are held as competitors under their government's health agencies, which require restructuring and fines for under-performance, errors, and patient dissatisfaction.

CPGH and its anti-competition backers are not "god" and they will not "make us all sick" if there is competition. They can only be driven to perform even better.

Allen
618
Points
Allen 01/25/12 - 06:52 pm
0
0
Not An Anti-Competition Backer

Borough taxpayers don't want UNFAIR competition and that is what the surgical center is. The surgeons' poposal cherry picks the less costly outpatient surgeries (and full pay patients) away from our community hospital that is required by law to provide the full menu of hospital services, including much more expensive surgeries and to take all patients regardless of ability to pay.

If the surgeons wanted to open a full service hospital in Kenai that was as regulated as CPH, that would be fair competition, and I would have no problem with that. But that's not what is happening.

"carver" keeps stating that the "original mission of CPH was a place for docs to ply their trade." This statement is bunk. The hospital was not built for the benefit of local doctors, it was built to provide health care for local residents. The doctors have to apply for "privileges" to practice there, it's not a right.

"carver" complains about competition between the hospital and the 8 Kahtnu surgeons, but he doesn't provide any facts as usual. From what I know, some doctors are or were asking to become employees at the hospital, because they want to practice medicine and not fight with the insurance companies over getting paid. And when some local doctors started refusing to take new Medicare patients, our hospital jumped in and opened up a clinic that takes Medicare patients. If this is the competition that carver is complaining about, I don't think it's a bad thing.

How hypocritical of carver to accuse hospital supporters of being anti-competitive and then in the next sentence complain about the hospital competing with local doctors.

granny
160
Points
granny 01/25/12 - 07:13 pm
0
0
Breath of fresh air

All these postings and no one was called an idiot!! This is the way it should be, thanks and good job guys. If the hospital has money-losing aspects, then any profits should go to those operations and not other organizations. Especially not the Kenai river guides. M Schrag

Allen
618
Points
Allen 01/25/12 - 08:37 pm
0
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Hospital Supporters Aren't Anti-Competitive

It's pretty hypocritical for carver to say hospital supporters are anti-competitive, and in the same sentence complain that the hospital competes with some local doctors.

Carver
1118
Points
Carver 01/26/12 - 06:39 am
0
0
Say what?

Hi Allen,

Please refresh my memory . . where did I say hospital supporters are anti-competitive?

Let me clarify my opinion: CPH was originally conceived and implemented as a facility where docs could do what docs do to the benefit of area residents. From those practical beginnings, CPGH Inc., the self-appointed board that runs CPH, has maneuvered CPH into a position of competition with area docs.

Now competition is generally a good thing, isn't it? Competition benefits the consumer by supplying the free market the impetus to operate efficiently, lowering prices to the benefit of the consumer.

Hospital supporters? I am a hospital supporter! I don't want to see CPH go away, nor will it. But I also support free enterprise and competition. Don't forget, it was CPGH Inc. who began competing with area docs. Who can blame the docs if they want to compete with CPH for day surgeries, a great percentage of which now leave the area, with their own surgery center?

No, competition is a good thing. My bet is that the proposed surgery center will be a good thing, drawing even more business and tax revenues to the area, making Kenai/Soldotna an even more comprehensive medical center.

kenai_kid
222
Points
kenai_kid 01/26/12 - 03:29 pm
0
0
Carver conflicting posts.

In your 1/25 post at 9:14 AM

"No, I'm afraid that the mayor's and the assembly's positions are but one more reflection of the disconnect between average Americans and the people we vote into office.

"All we, the public, can do is to note such things and remember them the next time these people come asking for our votes."

And then in your 1/25 11:16 AM post:

"Finally, relax, whether or not the CON is granted is up to the state to decide, and I'm pretty sure they have better criteria by which to decide than doom-and-gloom, public opinion."

The "state" is representative of the people and were elected by the people just as the borough assembly and mayor were. Your two posts contradict each other. In the first, you imply it is the elected officials duty to do the will of the people, and if they don't they should be voted out.

In your second post, you state that the elected officials have better criteria to make such decisions than the public does. But if they make a decision contradictory to public opinion, they have a "disconnect?"

robert white
378
Points
robert white 01/26/12 - 04:39 pm
0
0
CHP

So what do you tell people who don't have ins. and could save a lot of money money .??? to bad, get another job, move,tuff s---..bankruptcy dude, our silver spoon mayor could care less!!!

bewildered
9
Points
bewildered 01/26/12 - 05:37 pm
0
0
Choice? do you really think

Choice? do you really think you will have a choice? I dont know about any of you all but I can not schedule my own surgery. Can any of you?

So who really has the monopoly?

Hmmm
4
Points
Hmmm 01/26/12 - 07:32 pm
0
0
Surgery Center

Well, I for one do not want to find myself in trouble in a surgery center, waiting for an ambulance to come from Soldotna and drive me to a Hospital already irritated with the business I was injured at. Surgery centers have their place: Large cities with ample Hospitals within a few miles in case something goes wrong. They don't have the full suite of caregivers, however, needed to be self sufficient. It is unlikely that the surgeons who have subscribed to this idea care, as their profit margins will increase, they won't have to take Medicare/Medicaid and their requirements to public oversight will drastically diminish. This will simply leave us without those services. I hope that the surgeons decide to reconsider their affiliation with Kahtnu and return to providing good services for the community and that the hospital removes the privileges of those who don't. We don't need greedy surgeons in our community preying on us.

Jerry
0
Points
Jerry 01/27/12 - 01:50 pm
0
0
Well i recon ifn Navarre is

Well i recon ifn Navarre is agin it, then i'm fer it.
I sometime wonder out loud about people like Navarre & his support of, or lack of, for differant things.
Is this a reverse psycho thingy, or what, and who really cares what Navarre thinks?

My question is what does Fred think about saving OUR Bread? I bet he would be fer it, and not agin it.

Is it that he, Navarre, knows that many differ from him to the point of they will support anything that he is against, like this Surgical center, and thats why this article about his opinion?

All i know is that the Kenai is growing & more places of medical helps are needed.
I notice that there seems to be a moneyopoly of some sort totally surrounding CPGH.

OOPS! Did i say moneyopoly? I ment to say monopoly, which makes me wonder why all the fuse about another business of like services.
These services, that i know alot of people go to Anchorage for, all due to a small number of service providers here.
Also did any of you know that CPGH supposedly owns all the outpatient clinics in Sterling & Kenai, sounds like a Moneyopoly to me?
If we only knew the half of what CPGH owns & controls.

If these providers, businesses are paid by insurance, as most are, then whats the beef with providing more for our citizens here on the Kenai?
It all sounds kind of fishy to me, this desire to stymie growth on the Kenai, but then i do tend to see things in a differant light from most smart folks, but what do i know?

Ya should have used your head, and voted for Fred, i recon.

mkbstudent
0
Points
mkbstudent 01/27/12 - 08:45 pm
0
0
Analogies

Competition is okay of you compare apples to apples. But in this case, that will not happen. Look at our healthcare system like a train. Is it okay to make it go faster to get where it is going, sure. But what if there is a huge bend in the track and you are still giving it power you will derail it without a doubt. If the Surgery Center is approved than it needs to have the same regulations as the hospital and cover the same individuals. If the hospital is required to cover 30% that can not pay than so should the Surgery Center. Fair is Fair and Competition has to be fair too.

RaySouthwell
953
Points
RaySouthwell 01/27/12 - 10:16 pm
0
0
Folks

Many of you believe the CON will stop the surgeons desire to build an ambulatory Center. It will not. This is only the beginning.

History of Certificate of Need- Supported and passed in 1964 in New York State. In 1972 Became mandated by US Congress and signed into law by president Nixon. All States had to comply.

By 1986-Free Market advocates had the federal law repealed. Depending on what you read 15 States have repealed their law of CON.

Our State Senator Tom Wagoner has supported the repeal of the CON. Local Dr. Nels Anderson ran against Wagoner , in part, because of the concern a repeal of the CON would harm our hospital.

I wonder if Tom Wagoner would introduce a bill in the State Senate to repeal CON today? I wonder if Providence Hospital would like to see CON repealed and could get support from the Senators in the Anchorage area?

I have gone on record that either option for or against Kahtnu will harm the community because it divides us.

Healthcare dollars are shrinking and our community will battle over those dollars. We will all lose in the end.

Why after 40 years of a working relationship have the surgeons taken such great risk? Many here believe it is about making more money.

It is about independent surgeons attempting to keep control of their practices.

looseleif
11
Points
looseleif 01/28/12 - 04:49 pm
0
0
no insurance

Norseman & company and opponents: No one, and i mean no one, has answered my question. All you do is drag out the red herrings. Question: How do you justify denying medical care to the 1/4 of the population (actually, it is higher in
AK if you subtract the natives and the Native Health Care) that doesn't have insurance? Sure, some if them will have some savings, some will make deals with CPH's finance Department. But you all are determined to deny the rest. Maybe the lower costs at Kathnu will give them a chance - or maybe Kahtnu will deny them and the rest of us will be forced to raise our taxeswhen they can't pay CPH. Or maybe they just won't be able to afford either. But as it stands right now, 'Day Surgery" is CPH's profit center and they've got the poor locked out.

JOAT
487
Points
JOAT 01/28/12 - 08:52 pm
0
0
CPH treats everyone, Kathnu won't

Bull!!! Anyone and everyone has full access to CPH. They are not "locking" anyone out. I used to be quite "poor" and had no insurance. The surgical services at CPH didn't even flinch at that when the need arose. So I know from first hand experience that CPH will service anyone and everyone.

This day surgery center sounds to me like a bunch of prima donna surgeons who are not happy about their salary at CPH after all the money coming into surgery is distributed throughout the hospital to support other departments that don't make enough money to cover their costs. The surgeons are the greedy ones here as they abandon our great community hospital to strike out on their own venture where they get to keep all their profits. At their new for-profit surgery business, they not only get to pick and choose the cases they want (thereby locking out the poor), but they'll be able to buy that new luxury riverfront mansion, Willie Predator, and a fully loaded Dodge Ram 2500 to tow it.

Follow the money folks.

Norseman
3202
Points
Norseman 01/29/12 - 12:30 pm
0
0
looselief

No one is turned away at the hospital. If you think the surgeons are going to accept patients without insurance or the ability to pay, you are very naive.

They are pursuing this because of the profitability period. My only concern is that our hospital will be loosing the monies they would be getting if this goes through. If that happens, then us, the property owners will see increases in the mill rate.

JOAT
487
Points
JOAT 01/30/12 - 07:05 am
0
0
The public needs more info on the CPGH, Inc. Board of Directors!

I thought that we, the people, voted on the board that governs CPH, but I was wrong. A little more digging into the CPH managment structure and I found that there is an internally elected 11 member Board of Directors and then there is a completley separate and publically elected 7 member Service Area Board. The later deals with spending our tax money on the hospital and related ventures. The former is the BOD that actually runs CPH.

An interesting tid-bit popped up right away... the President of the CPGH BOD is a resident of Los Angeles, CA and attends the monthly meetings via teleconference. Perhaps that speaks volumes as to the management of CPH as a whole.

How about some investigative reporting on the internal management of CPH. Ya'll do have some reporters over there still, right?

RaySouthwell
953
Points
RaySouthwell 01/30/12 - 11:40 am
0
0
Joat

Joat,

You raise a great issue. An investigation?

For the record. The CPGH INC board represents the management at CPH. The Service Area Board represents the owners. They are an advisory group to the Borough Assembly who are to represent the people/owners.

I am unaware of the Borough Assembly, ever, agreeing with the the Service Area Board, they always agree with the management.

In October 2009 the Service Area Board voted unanimously to have an “operational audit” of CPH. The Borough Assembly ignored the recommendation of the Service Area Board.

It has been my experience small local newspapers like the Clarion have little resources to do an investigation of large employers like CPH. They fear law suits and CPGH INC. may be the largest advertiser in the Clarion. In these troubled economic times who in their right mind would ever bite the hand that feed so many.

bewildered
9
Points
bewildered 01/30/12 - 12:20 pm
0
0
.

.

bewildered
9
Points
bewildered 01/30/12 - 12:24 pm
0
0
Joat,It looks like you

Joat,
It looks like you missed a few details about the Board memeber you are "investigating" :
full time Researcher and Science Program Advisor in the Division of Gastroenterology and the Inflammatory Bowel and Immunobiology Research Institute at Cedars-Sinai Medical Center in Los Angeles, California. She has been involved in research for nearly thirty years. While telecommuting most of the time, she continues to travel to Los Angeles from the Kenai Peninsula for her work.

This board memeber maintians a home and a family here on the Kenai but mearly communtes a bit for work. Where is the problem with that? last I checked the job market in Alaska was not very wide for this type of speciality in healthcare and only adds to the value of knowledge on the board.

RaySouthwell
953
Points
RaySouthwell 01/30/12 - 12:53 pm
0
0
bewildered

It is my understanding the banker on the board lives with his family in Anchorage. I guess it doesn’t matter, he owns property here (I think) and, we the people, are not smart enough to find local folks to be on the Corporate Board.

RaySouthwell
953
Points
RaySouthwell 01/30/12 - 12:59 pm
0
0
Joat

Regardless, the Hospital INC. Board represent the management of CPGH INC., not the people/owners.

The Borough Assembly and hospital Service Area Board represent the people.

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