Cost of a new hospital is a necessary woe

Mr. James Preston’s letter last week recognized that the community wants and needs a Critical Access Hospital, but took issue with the cost of the proposed new facility. Perhaps to him, as to me and no doubt you, $10 million dollars sounds like a lot of money.

But as the cost for a medical facility to serve a large region, it is a very modest cost indeed.

In times past, when the idea of a new facility was discussed – as, it seems, it has been on and off for many years – the size and cost were always much more, one is tempted to say vastly more, than the design and cost estimate now in hand from an architectural firm. The current design, which should be available for public inspection next week, was scaled down several times from the general ideas that had been current in earlier discussions. It is a design that is about the functional minimum that is reasonable – there are no frills or extras here. Moreover, and fortunately, in just the last few years there has been substantial progress in understanding among architects about how to best design medical-facility layouts to optimize usage and internal traffic flow so that the ongoing day-to-day costs of running the facility are also lowered and efficiency improved.

It is important to understand how such a facility is cost-estimated, and it is a simple process. The per-square-foot costs of design and construction of such facilities are very well known from experience with building similar structures in similar communities throughout rural eastern Washington; the architects making the estimate have themselves done several in just the last very few years, and they have access to data from all round the state. Costing is done by simply reckoning how many square feet of each major type of service – medical work, administration, maintenance, whatever – there are and applying the well-known per-square-foot costs.

Thus, the cost question is really a size question; and the facility being designed is as small as can be plausibly effective. It will have the number of hospital rooms and clinic examining rooms that actual EARH experience plus established medical good-practice standards dictate, and no more. There is zero “pie in the sky” here. Nor is the District getting significantly smaller or older with time: it reached a stable level of size and age quite some time ago.

Finally, Preston asserts that the District “should keep our present hospital activated.” Did he not attend any of the open house Town Hall presentations? Does he not know that a major national engineering firm predicted that the current facility will have further numerous expensive system failures likely in or around 2017, only four years from now? With the best of will, the District simply cannot just go on indefinitely doing “business as usual,” because it does not have magical powers to halt the deterioration over time of structures and systems.

Eric & Lynn Walker, Ritzville