BY RICHARD SKOLNIK
White Rock
In Los Alamos, we regularly discuss healthcare issues such as insurance, shortages of healthcare providers, maternity care, and the future of the Los Alamos Medical Center. Yet one question almost never gets asked: “Who is responsible for making sure our community has the health services it needs?”
Most states rely on local or regional organizations to coordinate health planning and bring together key stakeholders. In New Mexico, although County and Tribal Health Councils perform some health planning functions, no single body coordinates the broader development of local health services across the institutions that shape access to care. This contributes to gaps in the provision of healthcare services in Los Alamos, as well as in other parts of New Mexico.
Without a local or regional health planning authority, most “discussions” on local health policy matters in Los Alamos take place on Facebook and in the Los Alamos Daily Post and The Los Alamos Reporter. While these conversations show how much people care, they do not provide coordinated solutions to local healthcare issues.
In this light, I want to suggest that the County promptly convene a Healthcare Working Group that would include representatives from LANL, the Health Council, and the Los Alamos County Council. They can invite others to join, as needed and appropriate. The Group’s role would be to identify priorities for health services in our area, improve communication among stakeholders, and help develop coordinated solutions to important healthcare challenges.
LANL is one of the largest employers in New Mexico and has a direct interest in ensuring that employees and their families can obtain high-quality healthcare. Better healthcare services locally and in New Mexico more broadly should assist LANL in recruiting and retaining needed staff. Nonetheless, the Laboratory appears to play only a limited role in local health planning.
Many questions have been raised about the role of the LAMC, especially since it stopped providing maternity care. It would, indeed, be wonderful to have high-quality maternity care in Los Alamos. However, population size and staffing requirements make this unrealistic, especially for a hospital run by a for-profit company. In addition, the idea that LAMC can become a “high-level hospital” is also unrealistic, given the size of our population, the healthcare services now available in Espanola and Santa Fe, and the challenges of recruiting and retaining healthcare providers in New Mexico.
Rather, I believe that we should seek to have a hospital that can provide to a high level of quality the services one should expect from a “rural” hospital: core emergency services; the highest priority outpatient services; radiology and laboratory services; and, very carefully selected additional services that can be carried out effectively.
Los Alamos deserves more than informal debates about healthcare. Rather, it deserves an ongoing community process to help shape healthcare services that best meet our needs.
Richard Skolnik is the former Director for Health for South Asia at the World Bank. He also served as the Executive Director of a Harvard AIDS treatment program for three countries in Africa and taught Global Health at the George Washington University and Yale. Richard is the author of Global Health 101, Fourth Edition, and the instructor for the Yale/Coursera Essentials of Global Health.
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