Endorsement: Measure E

“Hospitals alone remind us of the equality of man” – W.H. Auden

To have a hospital or not to have a hospital? That is the question Sonoma Valley Healthcare District voters will ask themselves June 6, when they consider Measure E – a $250 a year parcel tax that would bring in $3.8 million annually to make up for about $1 million (and growing) in total operating losses the district suffers annually.

For years the district has been in the red – and we don't mean from blood donations. More than 70 percent of services go toward patients on Medicare, or similar government-subsidized programs - and the hospital takes a loss on much of it, as government and commercial-insurance reimbursements grow stingier and more restrictive with each passing year.

The situation is nothing new. The healthcare district has relied upon the tax since 2002, when voters passed its first levy to the tune of $130 per parcel. The tax has been renewed in five-year increments twice since then, returning this time to seek another five years at $55 more than the current $195 tax, which expires June 30.

In past elections, district voters have generously supported the hospital, with the tax comfortably surpassing 70 percent approval. Conscious of that history, when renewal of the tax came before voters earlier this year as Measure B, healthcare district officials staged a “stealth campaign” in the hopes that a similar support would manifest at the ballot box as it had the past three go rounds.

But if there's one thing we've learned about elections this year – past voter patterns are no longer dependable gauges of current electoral winds. And, sure enough, Measure B narrowly failed to earn its necessary two-thirds approval.

With less than two months until the parcel tax expires, hospital finances – and therefore the hospital itself - is on voter life support.

And, like any Hippocratic-oath-taking physician worth her stethoscope, district voters should, “first, do no harm” – and vote a firm “yes” on Measure E.

Before we get into the reasons why a rapidly aging Valley would want a central location for its nearest emergency room, we'd like to address the most frequently cited reason for not supporting the tax: That the hospital should either embrace austerity measures or contrive some sort of revenue-generating brainchild in order to balance its budget and not seek voter assistance.

In other words, it's the old refrain: run it like a business.

Adherents to that line of thinking, however, suffer a fundamental misunderstanding of the role of public institutions, aka the commons, in that, well, they aren't businesses.

They don't operate from a profit-motive mindset – they operate from a serving-the-community mindset. And it would be unethical any other way. Hell yes, emergency room visits are a drain on the pocketbook; damn, if birthing babies isn't a wet diaper on the bottom line. You know what else is a drag?

A heart attack and a 40-minute drive to Santa Rosa Memorial; a brain hemorrhage stuck in wine-tourist traffic on the way to Queen of the Valley. That's what we're faced with if Sonoma Valley Hospital were to shutter.

We look at it in practical terms: Sonoma Valley's leans to the older side, and it's leaning more and more that way for the foreseeable future. Meanwhile, government and private insurance medical reimbursements for those older patients will continue to shrink. No viable “business” provides its services for less than cost – but community hospitals do. And thank goodness for that. We at the I-T have heard no shortage of opinions about Measure E – both in support, and not. Those opposed argue the “run it like a business” angle and suggest the price of a hospital is one tax too many. We get that. We simply don't agree.

Sonoma Valley Hospital isn't a perfect hospital. We doubt a perfect hospital has ever existed. Yet, all hospitals have their moments of perfection – at least in the eyes of some patients, whose opinions count above all.

There's the local couple who wrote us about the time years ago when SVH stabilized their 3-month-old threatened with Sudden Infant Death Syndrome; a man addressed the City Council this week to praise the hospital following a pulmonary embolism last month; a notable letter writer (see today's letters to the editor) drove himself to the ER in March for fear he was suffering a stroke.

We've heard countless such stories in the approach to the parcel tax election. And they can't be dismissed as merely anecdotes about good service; one can't calculate the value of a life potentially saved at the bottom of a financial spreadsheet.

We at the Index-Tribune felt the value of SVH two years ago when our longtime managing editor and friend Bill Hoban suffered a serious heart attack – Bill's fine today; thank goodness his emergency care was merely a few blocks away.

Odds are we'll all be in medical emergencies like that at some point in our lives – and, rest assured, none of us will complain that we'd paid a parcel tax to keep that hospital close at hand.

On June 6, the question for Sonoma Valley will be simple:

Will we support our community hospital for an additional $1 a week? Or will Sonoma Valley cut off its nose to spite its face?

And if it does, who's going to be there to mend the wounds?

We recommend a “yes” on Measure E.

Jason Walsh, editor

John Burns, publisher