Riverpoint needs healthy medical community

Spokane business and academic leaders reveled Wednesday in the start of construction on the $33.8 million Academic Center that will anchor the Riverpoint Higher Education Campus. When completed, said Washington State University President Lane Rawlins, the center will be a gateway not only for students, but for all of Spokane.

The project got a boost from the increasing cooperation among the area’s institutions of higher education and, though not directly, the University of Washington, which did not make an issue of the substantial expenditure despite the absence of a similar-sized project at its Seattle campus. With tight state budgets squeezing expenditures for higher education, the campuses have apparently set aside their propensity to fight over every nickel.

The Riverpoint campus, and the University District envisioned for the surrounding area, has become a priority for community leaders long aware the city’s lack of a research institution was a major impediment to attracting high-tech industry and high-wage jobs. Hopes are high that a proposed $34.6 million nursing center, together with the existing Health Sciences Building and a $6 million SIRTI Technology Center in final design will spin off graduates and ideas that create new businesses.

Some of those programs are already in place, and others are close to launch.

WSU, for example, offers a bachelor’s degree in exercise physiology and metabolism, and a doctor of audiology at Riverpoint. A $5 million grant will support a new sleep research effort under the supervision of Dr. Gregory Belenky, formerly of the Walter Reed Army Institute of Research. Other initiatives are under way in genetics, substance abuse and mental health.

A small cluster of bio-medical companies is shaping up in the area.

All these developments are good news. But the master plan for the district has always been predicated on the potential synergies with the area’s medical institutions, and there the news is not good.

Sacred Heart Medical Center and Deaconess Medical Center have announced layoffs or reductions in hours that will affect more than 300 employees. Neither institution can continue to absorb the costs of treating patients unable to pay their bills. Uncompensated care exceeds $19 million in Spokane County, $318 million statewide. More than 37,000 residents, almost 9 percent of the county’s total population, have no health insurance. Thursday, new U.S. Census Bureau figures indicated the number of uninsured nationally continues to increase.

Inadequate Medicare and Medicaid reimbursements amplify the problem. The Washington State Hospital Association says the federal and state payments fall about 5 percent short of meeting hospital costs even with supplements provided for indigent care. Unreimbursed Medicare and Medicaid expenses at Sacred Heart exceed $10 million.

All medical service providers in Washington continue to suffer under a Medicare reimbursement schedule that penalizes their efficiency. In 2000, the state ranked 42nd in the level of payments. Because the schedule works to the advantage of populous states with more clout in Congress, the state’s delegation has made no headway pushing for a more equitable split of the available federal dollars. Recent changes in Medicaid by the state had the unintended effect of discouraging many who need help from applying.

The response in Washington, D.C., is denial, if not worse. A Bush administration official deliberately denied Congress estimates of the true cost of the Medicare prescription plan before members voted on the bill.

The system will probably have to break before lawmakers undertake reforms that might restore some equity to the reimbursement formula.

Valuable as the research programs and innovative classes at the Riverpoint campus may prove to be — and the quality of the scientists attracted to the campus is certainly encouraging — the cooperative ventures envisioned between the campus and Spokane’s excellent medical facilities will suffer if those institutions continue to struggle financially and cast off some of the skilled practitioners already in the community.

About 20 percent of all economic activity in Spokane County is driven by the health care industry. Payroll related to all health care-related activity downtown and at the South Hill hospitals, at $600 million, is 10 times that generated by University District academia.

By all means, let the Riverpoint campus flourish, but let’s keep in mind the means needed by our bedrock medical institutions.