The “Better Together? An examination of the Relationship Between Acute Care Hospital Mergers and Patient Experience,” published in the Journal of Healthcare Management, clearly shows that the quality of care and patient experience after three years is no better and very often less than before the merger or acquisition. This leads me to ask the following questions all of us should consider ahead of the April 18 ballot measures. 

• What price do you put on having our own voice in the care and services our community provides? Should we vote to have SEARHC take control of the clinic for $1, we no longer have that voice. Is there a representative from our community on the board of directors? Yes. Is she representative of the nine demographics in Skagway represented by the current board? No. We as a collective no longer have a voice. 

• The Municipality of Skagway (MOS) Clinic Budget line item should be looked at as a line of credit. Public information on the MOS website shows the Dahl Memorial Clinic has met budget or well below since 2015. The “black hole” subsidiary has been grossly misrepresented. Roughly 95% of the subsidy comes from visitors. If SEARHC takes over and increases fees, the brunt of increased patient chargers will be felt by residents who use the clinic.  

• Other departments of the municipality “lose money” in the best interest of the community. The recreation center would be a prime example. We choose to support the rec center, the fire hall, the school, because they have a direct impact on the quality of living in Skagway and why we choose to live here. The clinic is no different.

• The primary focus should be on patient experience and quality of care. The conclusion of the study referenced at the start of this letter which included 198 hospitals states, “…mergers did not result in improved patient experience rating and nurse communication ratings increased at a slower rate than those that did not merge. And highlight the potential negative impact of the consolidation of … health systems.”

• SEARHC has not committed to keeping any current staff and did not answer the question if current staff need to reapply. If they bring medical staff in to fill gaps, what is the likelihood they will stay? What type of culture will SEARHC provide to encourage them to stay when the leadership does not live here to form relationships with the community?

I do not feel we have all of the details needed to make an informed vote. Our best option to maintain affordable healthcare opportunities in Skagway is to Vote FOR “The E.A. & Jenny Rasmuson Community Health Center building and the Dahl Memorial Clinic business shall NOT be leased or sold without ratification by public vote.” And to vote AGAINST “Shall the Municipality of Skagway lease the E.A. and Jenny Rasmuson community Health Center building and land for $1.00 to SEARHC and sell the Dahl Memorial Clinic business and assets for $1.00 to SEARHC?”

-Cory Thole