Before last night's vote by the combined legislatures of Lehigh and Northampton County, enough hot air was generated by public health and personal responsibility advocates to heat the County for the next five years. Twenty-nine people spoke to a standing-room only crowd, and twenty-two of them supported the measure.
Public Health Advocates v. Personal Responsibility Advocates
"It's time for a change," said dietitian Jane Ziegler, wearing her white lab coat for effect. Retired surgeon Michael Sinclair called the proposal "creative" and "brilliant." "Good bargains are hard to find," he said. Auto dealer Andy Daub tried to close the sale, calling a bi-county health department an "investment" that will somehow decrease the cost of health care. "We've got to compete with Bucks County or we're not going to get the jobs. ... They're gonna' walk right by us."
But the high local cost of Bucks County's health department, estimated at somewhere between $4 and $6 million, was used by personal responsibility advocates to argue against a bi-county health department. Former LV Congressional candidate Mat Benol told Lehigh and Northampton County legislators that "no amount of money is going to make people stop going to McDonalds."
Scrappleface, aka former LC Exec candidate Scott Ott, scoffed at the notion that a bi-County health department would be cost efficient. "You have to ask yourself, if two counties are good, why isn't four counties better? If four counties would be better, why not a twelve-county coalition? If a twelve-county coalition makes sense, how about a sixty-seven county coalition? Because certainly, the higher we roll this up and the more regional coordination we have, the better the care would get, or so you've been led to believe. So why not have Governor Rendell coordinate everything from Harrisburg, or President Obama coordinate it from Washington, D.C." He later said, "You don't have to rescue us. ... You cannot solve every problem."
We're Too Fat and Our Babies are Too Skinny
After hearing from the unwashed masses, the next people up were LV Health Board members.
Dr. Eric Gertner explained why we need public health. For one thing, we're too fat. In Northampton County, 30% of us are obese, and Lehigh County is only slightly skinnier, at 26%. If Northampton County were a state, the only ones that would be fatter than us would be Mississippi, Alabamy, West Virginy and Tennessee. It's like we're in Deliverance country. The truth is that Northampton County's obesity rate would go down ten points if I just moved.
While we're too fat, our babies are too skinny. 8.3% of Northampton's babies have a low birth rate, while Lehigh County is even worse, at 8.7%. Even Mongolia does better than us. But don't Mongols have anger issues?
John Reinhart, another Board of Health member, explained the nightmare he went through when he had to distribute H1N1 vaccines at the Bangor School District. "There seems to be a comfortable belief that we in the LV will be taken care of by some agency or some group, and that agency or group will not permit us to be vulnerable during a public health crisis. I personally believe that's clearly a misconception. ... We reached out last Fall during H1N1, and with the exception of Allentown and Bethlehem, there really wasn't another person on the end of the line for the rest of us."
Health Board member Ilene Prokup told legislators of plans for 5 clinics in Allentown, Slatington, Bethlehem, Easton and Bangor. She also said the staff would grow from 66 to 106 in the first year.
Lehigh and Northampton County legislators had several objections.
Bruce Gilbert (North.) was doubtful about the 3% projected annual growth, believing the figure will be much higher as a regional health board competes for grants with Philly and Pittsburgh. "I don't see that as a realistic figure as to what our cost increase will be. I'm not sure we're getting an accurate picture ... ."
Glenn Eckhart (Leh.) noted that 66 public health workers currently serve 175,000 people in Allentown and Bethlehem, and was very doubtful that an additional 50 workers could serve 600,000 residents in the LV. "Will this health department give equal coverage to the other 400,000? Until that happens, I can't support it."
The Northampton County Bulldog, Ron Angle, was in a foul mood. Chairman Percy Dougherty had started the meeting by saying any attempts to table the LV Health Department would be out of order, and he reached that conclusion on the basis of discussions with attorneys from both Counties. Angle asked County Council Solicitor Phil Lauer whether that was true, and Phil responded, "This is the first I've heard of it." Dougherty got his signals crossed somewhere.
Angle's chief objection (he had a few) is that Allentown and Bethlehem are guaranteed they will receive the same services from a Bi-County Health department that residents there currently enjoy. "This is a two-tiered service. If we vote against increases, Allentown and Bethlehem will still get the same service and everyone else will suffer." He also ridiculed the numbers in the proposal, calling them "pitiful."
Lamont McClure (North.) delivered the most damaging assessment. He had previously boycotted all meetings concerning the establishment of a Bi-County Health Department, and noted that "we've been lectured about our responsibilities", "our failure to provide for public health." Then he delivered a lecture of his own, telling health board members that the County's source of revenue is real estate taxes. "There is a crisis in Pennsylvania, but it is of people trying to stay in their homes." He noted many good people are just "one pink slip away from foreclosure," and read minutes from previous presentations establishing that local hospitals want public health so they can get people out of their emergency rooms.
McClure wanted to know if hospitals were willing to fund the County share for the next five years. Board member David Beckwith conceded that, although hospitals were more than willing to provide in-kind services, they will make no cash contributions.
This seemed to set off the normally affable Dean Browning (Leh.), who agreed with McClure that "we have been somewhat lectured to tonight." Of the hospitals' refusal to commit any cash, he stated, "They damn well should support us because they are not paying any property taxes." Browning noted that, in Lehigh County, hospitals are exempt from $8.1 million in real estate taxes. "If they want a Bi-County Health Department, they should put their money where their mouth is and fund it."
Mike Dowd (North.) noted that satellite offices would be established "when deemed appropriate," and questioned why that was not already determined. He shared Angle's concern about funding for Allentown and Bethlehem leading to shortfalls elsewhere. Finally, he'd like to see proof of the "salubrious benefit" of public health to students in Allentown and Bethlehem. (Mike talks like that. He reads books).
In addition to all these objections, there were other legislators who argued in support of funding a Bi-County Health Board.
Andy Roman (Leh.) trotted out the "Be afraid, be very afraid" argument, pointing to 9/11, bio-terrorism and our drinking supply. He also noted "we are already paying for services that we're not receiving from a system that is fragmented and has no local control. Conservatives should support this."
Gloria Hamm (Leh.), who had oxygen going up her nose the entire meeting, must have had her supply cut off by Angle at points. She was hopelessly confused before every vote cast, but dismissed the personal responsibility argument as some kind of red herring. She also noted that if one grant is denied, the health board can simply apply for another one somewhere else. I see.
David Jones (Leh.), who actually showed up for once, claimed he was no politician, but was a preacher. He condemned the "rhetoric" and "grandstanding" that had gone on "from both sides" and then delivered a sermon of his own. Arguments against the health board were "strawmans" [sic]. Those opposed are guilty of "unreasoned fear." Then he quoted from FDR, Martin Luther King and Adam Sandler.
According to Bill Hansell (Leh.), funding is imperative. "Listening to the opposition, I'm wondering what country we're in." Then he started quoting Jefferson, who incidentally helped Hansell draft the Declaration of Independence. By the way, I hate to break this to you, but according to Hansell, the health board report claims "we have cancer." Better see your doctor. He also insisted public health should be our #1 priority, more important than open space, bridges or even jails.
Percy Dougherty (Leh.) promises, "we're not going to saddle the taxpayers" with the cost of a health board, and claims he could transfer funds from "other programs." But he never identifies those programs.
Ann McHale (North.) had the usual trite comments. "Now is the time to make the tough choice. ... It's the right thing to do. ... It takes courage to do the right thing ... blah, blah, blah." I'm sure her Overlords at the Lehigh Valley Partnership were very happy.
Despite Dougherty's admonition earlier that evening, Angle moved to table the resolution for two weeks, pending receipt of a report on the County's nursing home. He was seconded by Dowd, who expressed concern about Northampton County's $16 million hole. But that motion failed. An attempt to offer amendments to the Resolution also fell short. That left the Resolution itself, which authorized funding, approved a budget and authorized establishment of a Board of Health. In order to pass, this resolution needed the support of five members of both Lehigh County's Board of Commissioners as well as Northampton County Council.
When the dust had settled, it passed in Lehigh County, 6-3. Only Browning, Tom Creighton and Eckhart were opposed. But it failed in Northampton County, 2-6. Only McHale and Peg Ferraro voted yes, with Tom Dietrich being the only member MIA from both legislative bodies.
What killed this proposal, in addition to poor advocacy and a condescending attitude from public health advocates, was the unwillingness of local hospitals to provide any kind of financial support for a program that benefits them at least as much as the public.
Funeral arrangements will be handled by David Jones' Life Church.