The legacies of Western North Carolina’s two previous Republican congressmen, Mark Meadows and Madison Cawthorn, haven’t exactly aged well. 

Democracy means that we voters get to decide with elections which candidates are empowered to serve in our local, state and federal governments. Those elected officials are supposed to serve us, not their own personal selfish quests for wealth and power. We want our political leaders to listen to our wishes and provide us with essential government services. 

To the Editor:

Everyone deserves to live a healthy life with financial security. We want to pay less for prescription drugs and live in a world that we can pass on to our grandchildren where carbon pollution is dramatically reduced.

To the Editor:

I’m writing in response to the “Democrats try to scare voters” letter in the May 8 edition of your paper. That idea is totally preposterous considering that the standard bearer of the Republican Party is a fear master.  

That the American health care coverage system is broken shouldn’t come as a shock to anyone, even proponents of the 2010 Affordable Care Act who thought Obamacare would make coverage affordable for everyone. But as long as workers with employer-subsidized health care are forced to rely on the generosity of capitalists for their health and well-being, there will continue to be crises like the one currently unfolding with soon-to-be unemployed workers at Pactiv-Evergreen’s Haywood County facilities.

The “Back off our Benefits” bus tour rolled into Asheville last week with one simple request — for Congress to protect Medicare, Medicaid, Social Security and veterans’ benefits. Western North Carolina Congressman Chuck Edwards (R-Henderson), who faced similar calls from Republican voters last fall, ignored them again.

By Steven Wall • Guest Columnist | With so much division in our country, and some  folks even losing faith in democratic government, I would like to offer a proposal concerning Medicare. I do this in the hope that such a proposal if implemented could help restore some  faith in  government. 

Unless a new agreement is signed, patients with Blue Cross, Blue Shield Medicare Advantage Plans will have to pay out-of-network prices for services at Duke LifePoint hospitals beginning Jan. 1, 2021.

By Martin Dyckman • Guest Columnist

The United States spends twice as much on health care as most other modern nations, with less to show for it in terms of longevity and other true measures of health. The reasons why — and what we could and should do about it — make the March 4 edition of TIME probably the most important single issue of any magazine ever published.

Steven Brill’s cover story, “Why Medical Bills Are Killing Us,” takes up nearly the entire edition. Anyone who cares about this — and who doesn’t — needs to buy or borrow the magazine now or download the article from TIME’s website. It’s a keeper.

Concerns among Jackson County doctors that Harris Regional Hospital is not thriving as it should under a partnership with Haywood Regional Medical Center has prompted a change in top leadership.

Harris once more has its own CEO, and Haywood will be under its own CEO. This marks a step back from the shared management structure the hospitals were moving toward.

“Right now, it is clear that we need to have two very strong managers focusing on their specific campuses,” said Fred Alexander, chair of the MedWest Board of Directors, the umbrella partnership for the Haywood, Jackson and Swain county hospitals.

Until last week, Mike Poore served as the CEO of all three hospitals as well as the umbrella partnership of MedWest. Poore has now been pulled back to his former role of being over Haywood’s hospital only. WestCare, which includes both Harris and Swain County Hospital, will have its own CEO in Steve Heatherly, who was second in command at WestCare prior to the partnership and since then has served the head of the MedWest Physician Network, which employs more than 80 doctors.

Poore said he wants whatever is in the best interest of all three hospitals, even if that means a change in his job title.

“We have to be laser focused on giving the absolute best care at each of our hospitals,” Poore said.

When Harris and Haywood hospitals formed a partnership two years ago, the CEOs of both applied for the top job over the new MedWest entity. While Haywood was seen as pulling for Poore, Jackson was seen as pulling for its own CEO at the time, Mark Leonard. When Leonard did not get the top spot, he left rather than staying on in some other capacity.

Now, Heatherly may be the next best thing. He has been at Harris since 1997, working his way up to CFO, chief operating officer and executive vice-president. Heatherly got his MBA from Western Carolina University.

Alexander said several physicians recently brought their concerns about the direction of Harris to the hospital’s board and management team.

“I think their sincere motivation is to try to see the hospital operating more smoothly,” Alexander said. “As a result we felt both hospitals needed to have direct hands-on management. Our whole desire is to resolve any issue that is present.”

And the clock may be ticking. If Jackson’s medical community isn’t satisfied, they could lobby to pull out of the MedWest partnership in 2013.

While dissolving the partnership may not be particularly easy, there was a clause in the contract forming MedWest that allowed for an out after three years — which is coming up next year. But it would take a super majority of MedWest’s board of directors to terminate the partnership. The board has 14 members — with Haywood and WestCare evenly represented with seven members each — and 75 percent would have to vote to dissolve. Barring that, legal arbitration could be an option.

Not uncommon hiccup

In addition to partnering under the MedWest umbrella, the entity also signed a management contract with Carolinas Health System, a network of 30 hospitals under the flagship Carolinas Medical in Charlotte.

Carolinas Health System has been an astute observer in recent years of mergers and partnerships playing out with smaller hospitals across the state. Hiccups like this are not uncommon, according to John Young, vice president for Carolinas HealthCare’s western region.

“We need someone living and breathing and spending all their time on each side,” Young said. “When you have people going back and forth you feel like nobody is getting the full attention of anybody. We decided it was time to make sure we had enough boots on the ground in terms of leadership.”

Neither hospital has a particularly easy row to hoe these days — whether together or alone. Hospitals and doctors have all been impacted by the recession, as consumers cut back on health care spending and insurance companies and Medicare lower their reimbursement rates.

But the financial challenges in Haywood and Jackson have been exacerbated by competition from Mission Hospital, which has been chipping away at market share of the local hospitals in recent years.

“We have lost too many patients out of our marketplace and that is putting financial stress on the entire organization,” Young said. “If we get grow bigger and get better a lot of this stuff will just fall away.”

The MedWest partnership is still relatively new, and there is naturally going to be an adjustment period as hospitals and doctors who used to be independent begin thinking collectively, Young said.

“We probably are moving it back a little bit form the direction we were going, but if that helps both sides be more successful, then it will help MedWest be successful,” Young said.

As the CEO of all three hospitals and MedWest at large, Poore brought a more collective approach that perhaps the hospitals and medical communities weren’t ready for yet.

“We haven’t been meticulous about accounting this widget went to that campus and that widget went to that campus, but we are going to start doing that,” Poore said.

Several administration functions have been consolidated by the partnership. MedWest shares a nutrition department, marketing department and purchasing department, for example.

But medical care and health specialties have not been consolidated, and there are no plans to make patients trek to either-or hospital depending on the type of treatment they need.

“The end game of everything we are trying to do through MedWest and the individual hospitals is to provide local services for local people,” Alexander said.

Alexander pointed out that if the business side of a hospital — namely how good or bad the hospital is faring — always seems to capture headlines, that’s because it is directly related to its mission.

“Most succinctly, if a hospital wants to do good for its community it must do well financially,” Alexander said.

Alexander said the hospitals may return to a single CEO model at some point.

“We don’t see this as a permanent set up, but for the foreseeable future,” Alexander said. “Change is your middle name if you are a hospital these days. In the life cycle for any organization the form has to follow the functions that are at hand.”