Mayor on Duty

I remained quiet and neutral during the election. Congratulations to those who won and to all candidates on the ballot. Thanks to everyone who took the time to vote.

Now I want to respond to a general notion that was manifested in various forms during the election. It goes something like this with an introduction statement, “What should the town do about . . . .”  One specific question concerned what the town should do about the hospital and healthcare.

I always feel uneasy about this notion of “The Town.”  It connotes “The Town” as some autonomous, self-supporting, corporation with unlimited resources. I wish the question was not framed with what’s  “The Town” going to do. I suggest an alternative of what the town taxpayers are expected to support.

The following two questions are very different: “What is the town going to do about the hospital and healthcare?” and “What are the taxpayers of Highlands expected to do about the hospital and healthcare?” The latter begs the question whether the taxpayers of Highlands should be directly or indirectly the sole bearer of support for the hospital’s longterm vitality. We should also remember that the current proprietor of the Highlands Cashiers Hospital, HCA, is a private corporation.

My point is that while some may think “The Town” should take action, possibly involving taxpayer money, the vast majority of beneficiaries reside outside of town and would not shoulder that tax burden. Maybe the question should be reframed to “What should the Macon and Jackson County taxpayers be expected to pay to insure the longterm access to healthcare?”

We have a Highlands’ fire district where town residents and those in the county all share the tax burden for fire protection. Why would a healthcare access scenario be any different?

Yes, I do become concerned when the sole focus of Plateau initiatives falls on “The Town.” We need to be forming partnerships from all local governmental entities, not just the Town of Highlands. Some effective partnerships already exist.

But, as I said HCA is a private corporation. That makes direct financial support from any elected government body problematic. On the other hand, we all have a crucial vested interest in assuring continued healthcare access in the Highlands-Cashiers area.

As mayor, I have a fiduciary responsibility to advocate for the community. Last Friday I attended a meeting of the Health Equity Coalition (HEC) in Asheville. This group evolved from the sale of Mission to HCA and the formation of the Dogwood Healthcare Trust. HEC has recently pushed for the hiring of a healthcare monitor, which was a condition of the Attorney General’s approval of the sale. After nine months, Dogwood announced the hiring of an independent monitoring firm last week.

Big questions remain? How will HCA invest in the future of the hospital? Given their collective focus on social determinants of health, what will Dogwood and the Highlands Cashiers Health Foundation do to insure basic healthcare access on the plateau?

“The Town” should play a supporting role, but I am wary of any expectation that Highlands taxpayers should ‘chip in” when others do not.

If more resources are required, maybe Jackson and Macon County support would be more equitable. After all Highlands residents not only pay town taxes, but they also pay a lion’s share of Macon County taxes. Some Highlanders even pay Jackson County taxes.

I remain optimistic. Hopefully, HCA and the Legacy Foundations have plans to address critical problems like access to primary care physicians and serving the under insured.

• Town of Highlands Mayor Pat Taylor