Amendment Could Affect Health Care

Idaho’s Constitution will change if voters approve SJR 111 on Tuesday.

Yet, few are familiar with the proposed amendment, which would allow public hospitals to form partnerships with private businesses.

Any discussion of the proposal - and there has been little - has been drowned out by the din over initiatives involving bear baiting, property taxes and nuclear waste.

The amendment could have a big impact on health care in Idaho, where two-thirds of the hospitals are public. Only one of North Idaho’s five hospitals, Bonner General, is privately owned.

The Idaho Hospital Association pushed for the amendment after decades of frustration by its members, said association President Steve Millard. Whenever public hospitals wanted to get into a joint venture with a private hospital or physicians group, they would run into a legal roadblock.

“In 1890, when the Idaho Constitution was drafted, they put in a section to make sure cities or counties did not use their taxing authority to pledge or give money to railroads so the railroads would come through their town,” Millard said.

Specifically, the section says that a public entity cannot lend its credit. That means no joint ventures, no risk sharing, no pledging of assets, no loaning of money.

For example, Kootenai Medical Center couldn’t jointly buy a laboratory with Spokane’s private hospitals, which it once considered.

Joe Morris, KMC’s chief executive officer, was among those who testified in the Legislature for the amendment.

He believes SJR 111 will give public hospitals more flexibility and improve health care services in rural areas, where hospitals are almost always publicly owned.

If the amendment passes, he said, one way KMC might use the new authority would be to consolidate its computer services with other hospitals. That would save money, he said.

Senate Joint Resolution 111 sailed through the 1996 Legislature. It needed only two-thirds of the lawmakers’ approval to get on the ballot. What it got was 90 percent approval in the Senate, 80 percent in the House.

No one testified against the proposal, although Millard acknowledged that the hospital association “didn’t go out and beat the bushes for opposition.”

The lack of public comment displeases Lee Schellman, a Coeur d’Alene physical therapist who also happens to be a member of KMC’s board of directors.

He wishes there had been public hearings.

“I honestly don’t believe the legislators knew what they were voting on,” he said.

Schellman worries that hospitals such as KMC could eliminate healthy competition by forming partnerships that overwhelm smaller businesses.

“We’ve got an outstanding hospital, but I don’t think they should get into businesses with other businesses,” he said. “In health care, bigger isn’t always better.”

Another critic is Brad Fowler. He manages Associated Internal Medicine, the Coeur d’Alene office of his physician wife.

“It concerns me a great deal that we give one of the most powerful entities in North Idaho that much more power,” he said of the hospitals. “Will private providers be able to compete with someone who, for goodness sakes, has the power to change the Constitution?”

, DataTimes