How to remedy Mission, restore great health care in our area? Competition


State House representative Brian Turner says HCA/Mission has used its position as the only hospital in Buncombe County as leverage to dictate prices.

State House representative Brian Turner says HCA/Mission has used its position as the only hospital in Buncombe County as leverage to dictate prices.

The writing has been on the wall for a while. In buying Mission Hospital four years ago, HCA sold us on their ability to continue high-level medical care for Buncombe County. They promised quality, affordable care in Western North Carolina. Of course we all worried about the purchase, but we knew that the state’s failure to expand Medicaid meant that Mission Hospital needed to take drastic steps. We held our breath and hoped that the HCA acquisition of Mission Hospital would be a positive step for Asheville.

Then came reports of doctors leaving, when Dr. Tom Large, who had plans to finish his career in Asheville as an orthopedic surgeon, told the Citizen Times in May of last year that physicians were fed up.

Large says in his opinion, which he then said echoed conversations with many other physicians at Mission Hospital, HCA “consistently demonstrated that all decisions are seemingly strongly driven by profit.”

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We watched as nurses protested about working conditions when back in January the Centers for Disease Control and Prevention shortened quarantine times, posing health risks.

“With the new CDC guidelines, there might not be a nurse able to take care of you when you come into the hospital,” Elle Kruta, a registered nurse who was working in Mission’s case management departments then told the Citizen Times. “We’re always going to fight to be by the patient’s side, but if we’re sick ourselves or the hospital doesn’t supply enough staff or the proper protective equipment, we can’t.”

Now we are turning blue.

In a time where health care has been at the top of everyone’s mind, we need to make sure that our area has access to high quality care and lower costs for that care.

HCA/Mission has used its position as the only hospital in Buncombe County as leverage to dictate prices, hold power while negotiating with insurance companies and providers, and reduce quality for the sake of cutting costs and pumping up the bottom line.

High-level medical care requires experienced practitioners. Because of growing frustration, we are seeing a loss of experienced physicians and nurses which leads to a lack of consistent patient care. They are frustrated by what they see, and members of our community are too. Not only are they losing their doctors, but their health care costs are rising, and their closest clinics are being shut down by HCA. Surrounding communities are now without their standard places to go for care. For four years we have all been deeply concerned about what is going on at Mission.

Just recently in a brief supporting the continuation of an antitrust case against HCA, Attorney General Josh Stein said, “Health care systems cannot be allowed to use their size and dominance to harm North Carolinians who need accessible, affordable, quality health care.” Sometimes it may seem that there is no answer to the problem that HCA’s acquisition of Mission created. Many have asked me if we are just stuck with HCA. Yes, HCA is here to stay but we don’t have to accept the status quo.

Thankfully, there is a path to restore great health care in our area: the possibility for a new game in town. Competition ensures lower costs for health care and serves as a catalyst for better quality of care and innovation. We’ve seen what competition can do in other fields. It may look like there is no way to have competition in our area because HCA holds monopolistic power here. But there is an opportunity at the statewide level to introduce a competitive playing field here.

The state has determined 67 more beds are needed for the Asheville area. Through the Certificate of Need (CON) application process, hospitals – including HCA – will compete for the chance to provide these new beds. Yes – HCA is the largest player here, but we can’t allow HCA to have these beds too without putting up a fight. We need another entity to apply and provide the opportunity to change the status quo, giving all of us a choice in our health care in Western North Carolina.

I want our community to have the health care we deserve and the kind of treatment we all remember receiving from the old Mission. I want to see confidence in the health care that Asheville has to offer again. We need lower costs for patients and a facility experienced nurses and physicians want to work in. Competition will bring health gains to Western North Carolina instead of just financial ones for HCA.

Brian Turner is House Representative for North Carolina’s District 116

This article originally appeared on Asheville Citizen Times: WNC: How to combat Mission, restore great health care in area?


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