Proposition 480

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Proposition 480 would give the Maricopa County medical care system nearly a $1 billion in new funding if approved. Dr. Kevin Foster, Medical Director of the Arizona Burn Center, will talk about the measure.

Ted Simons: Good evening, welcome to "Arizona Horizon." I'm Ted Simons. Proposition 480 on the ball ballot in Maricopa County this November providing $935 million for a new, expanded County hospital system. Here to talk about it is Dr. Kevin foster, medical director of the Arizona burn center. Thanks for joining us.

Kevin Foster: Thank you.

Ted Simons: What does prop 480 call for?

Kevin Foster: It calls for a new hospital. Our hospital system right now is comprised of a number of things including a hospital that is 40 years old, antiquated and obsolete, however what prop 480 really calls foregoes beyond the hospital. That's maintenance and advancement of programs that are critical to medical care in Maricopa County. That includes our level 1 trauma center, the Arizona burn center, behavioral health and physician training.

Ted Simons: We got 571 million for upgrade to the County hospital, couple hundred million to build a behavioral health facility, 138 some odd million to renovate. Why are the changes needed now?

Kevin Foster: They are needed because they have been needed for a long time. We have been operating on a shoestring budget for a very long time and operating in facilities that are old and antiquated. The time is now for this. We have the second largest burn center in the United States. We have a very large behavioral health program, and we have a level one trauma center that is second to none. We really want to advance these programs.

Ted Simons: We should mention there's no organized opposition to prop 480. The other side so far has not organized in opposition there are some questions, though, among the more philosophical questions, the future of medical care. Some are suggesting the future is steering patients away from hospitals and does that this may not be needed. How would you respond?

Kevin Foster: I think that's true. Trying to take care of patients as outpatients and avoiding long stays in hospitals is beneficial on a number of levels. That's something we try to do, however, there are some types of care that just have to be done in facilities and hospital systems. Certainly taking care of trauma patients, taking care of burn patients, and trying to take care of people with severe mental illness really require facilities in which to do that.

Ted Simons: There are some private hospitals expressing concern but compare what the County does to so many private hospitals around the valley.

Kevin Foster: Most private hospitals provide outstanding care but they also have business plans. What we have is patient care plans. Our critical mission, the focus of care at Maricopa, is to take care of the patient. We tend to take care of patients that have for place else to go. That's our mission and we want to continue that mission.

Ted Simons: And that includes folks level 1 trauma, obviously.

Kevin Foster: Level one trauma.

Ted Simons: Your burn center. That's a little bit different than private hospitals can handle?

Kevin Foster: It's a little bit different than private hospitals can handle because it's regionalized. It requires tremendous mobilization of resources, personnel, materials to take care of a burn patient that's going to be in the hospital three to four months. That's what we do.

Ted Simons: Same kind of situation with HIV patients I would imagine.

Kevin Foster: That's true. We have a large HIV program.

Ted Simons: So as far as the private hospitals, I know that Brazos and banner and Scottsdale Lincoln have said why don't we work some kind of public private partnership. We have extra beds, we have available beds. Maybe you could work something there.

Kevin Foster: Well, it's possible. However, as I have said before, our focus is on taking care of the patients and we're not as concerned with the bottom line. The bottom dollar. The other thing is that the number of beds that would be required to do what we do is astronomical. The health system as it currently exists in Arizona does not have that capacity. We take care of 20,000 inpatients, 300,000 outpatients. That's a lot of people to take care of.

Ted Simons: When people think of a County hospital and they think it's there and it's always been there and always going to be there, but I talked about the difference between you and private hospitals. Again, what separates the County hospital, the County health care system, and why does it need an infusion of $1 billion?

Kevin Foster: What makes County hospitals unique and safety net hospitals unique is that we take care of patients who don't have any place else to go. Patients who don't have funding or who are under-funded. Every major city, every large County in the United States has some sort of safety net hospital. Maricopa is the safety net hospital for Arizona and for Maricopa County. Our mission is to care for patients that really don't have any other place to go.

Ted Simons: When you mentioned the other hospitals, private hospitals have a business plan, obviously profit is the major motive there, should there be more of a business plan when it comes to County system?

Kevin Foster: We're certainly responsible to the good citizens of Maricopa County and we try to provide responsible medical care, but as I said before, at some point in time you have to take care of the patient. That's really what our focus is.

Ted Simons: So when people say this is an interesting measure we would like to support it, see more transparency, find out more where the money is going, is that a valid concern?

Kevin Foster: Absolutely. I think this process up to now and moving forward has been and will be completely transparent. We are a public government hospital, and we are beholden to the citizens of Maricopa County and we want this to be as transparent as possible.

Ted Simons: The Goldwater Institute is against this saying it could mean $1.4 billion in PNI and property tax increases as such. Do you think -- check that. Explain why it's worth it for the citizens of Maricopa County to get this done.

Kevin Foster: Right now Maricopa County hospital and MIHS system offers critical care that is not offered any place else. We already talked about the burn center, the trauma center, and behavioral health. In addition we train doctors for Arizona. We train 400 doctors every year and the doctors that graduate from our programs stay in Arizona. Three-quarters of them, 75%, stay in Arizona. There's already a physician shortage in Arizona, it's only going to get worse with time and we're doing our best to help with that. Now, -- The amount of money we're asking for is not very much, $13 per $100,000 of property tax. That is money that we haven't asked for for a long, long time.

Ted Simons: Are you surprised there's no organized opposition?

Kevin Foster: I'm not.

Ted Simons: You're not surprised.

Kevin Foster: No.

Ted Simons: Because those in the know think this is really needed.

Kevin Foster: Absolutely

Ted Simons: Alright good to have you. Thanks for joining us.

Kevin Foster: Thank you, sir.

Dr. Kevin Foster:Medical Director, Arizona Burn Center;

Ted Simons, host and managing editor of

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