As Dan Moller writhed in pain from appendicitis, he was pushed into an ambulance at the Reston emergency facility--known as Access--and taken to Fairfax Hospital, about 10 miles away. The 15-minute ambulance run convinced the Reston attorney and unsuccessful legislative candidate that northwestern Fairfax needs its own hospital.
Susan Jones says her 30-minute trip from Reston to Fairfax Hospital was too close for comfort when she was pregnant. Jones, president of the Reston Home Owners Association Council, says she went into labor after midnight and gave birth about three hours later. "It's just good it wasn't rush hour," she said.
Fairfax Supervisor Martha V. Pennino, who represents the area, has heard these stories and more and has set out on the uphill battle to get Reston its own hospital. Her latest effort is a motion, which the County Board of Supervisors is scheduled to vote on July 11, declaring that the next new Northern Virginia hospital should be built in the Reston-Herndon area.
To speed up the establishment of that hospital, Pennino's proposal also would establish as county policy that 90 percent of the Fairfax population should be within a 15-minute automobile ride of a hospital, and that there should be enough hospital beds to meet the demand of 65 percent of the county's population.
The first part of those guidelines would require that at least two new hospitals be built in Fairfax and the second part of the proposal would require the addition of at least 400 new hospital beds to the region, both of which are vehemently opposed by regional health planners, who say such an expansion could add hundreds of dollars to the hospital bills for the average Fairfax patient.
Even if the motion is passed by the supervisors next Monday, it does not necessarily mean that Moller and Jones will see a Reston hospital, or that any new hospital will be approved for suburban Virginia this year or next. That decision rests, not with the Fairfax supervisors, but with Virginia State Health Commissioner James B. Kenley and the board's motion is not binding on him.
Pennino, however, feels that an official board statement, particularly on the location of a hospital, should weigh heavily in any decisions by the state health commissioner.
And although many health planning experts do not expect a new Northern Virginia hospital to be approved this year, most believe that a new one will be established in Fairfax before the end of the decade.
Supervisor Audrey Moore, an Annandale Democrat who opposes Pen- nino's motion, said she fears that if the board approves the policy, it could provide evidence for any hospi- tal that might go to court to chal- lenge a rejection by Kenley.
If Pennino's plan is approved Monday, it would mark the first time that the board has interjected itself into the controversy over whether a new hospital is needed in western Fairfax, when it should be built, and whether it should be in the northern part, near Reston, or in the central part, near Fair Oaks Mall--both areas in Pennino's district.
Two hospital groups are competing for Reston and one is competing for a site in the Fair Oaks area by the intersection of I-66 and Rte. 50. Kenley has rejected the Reston application by the for-profit Humana Corp. and the Fair Oaks one by the nonprofit Fairfax Hospital Association, which operates both Access and Fairfax Hospital. Both groups are administratively appealing Kenley's ruling, and both already have indicated they may go to court if unsuccessful.
Kenley's ruling on the third application, by Hospital Corp. of America, to build a hospital in Reston, is expected July 11. Both the Health Systems Agency of Northern Virginia and the Statewide Health Coordinating Council, which advise Kenley on health planning matters, have recommended that the application be rejected.
Both health planning groups believe that there are too many empty beds in Northern Virginia and that the number of beds must be cut there, not increased.
They argue hospitals have high fixed costs, whether the facility is full or half empty. Therefore if a hospital is always full, it can charge less to patients than a hospital that is only 60 percent full.
So naturally, the HSA views Pennino's guidelines with horror. For instance, the HSA believes that since only 53 percent of the county residents use Fairfax hospitals, there is no reason to expand the number of beds to accommodate 65 percent of the population.
They believe many patients prefer to go to hospitals in Alexandria, Arlington or the District out of habit, preference or because their physicians are there.
That view is also echoed by the Fairfax Health Care Advisory Board, a citizens' task force set up to advise the supervisors.
According to the HSA, the Pennino proposal would require 400 extra beds, which they believe would sit empty or would cause beds in other area hospitals to sit empty. Construction costs of the new facility would be about $50 million, but total financing costs would be between $150 to $200 million.
The annual costs of operating those empty beds would be between $14 million to $27 million, which would add roughly $48 to $95 a day to the hospital bill of the average Fairfax patient. Because the average length of stay in Fairfax is seven days, the HSA calculates the average Fairfax hospital bill would increase by $336 to $665.
"That's a rather wild statement on their part," Pennino responds. "They're just using scare tactics."
Moore counters that if policy makers ignore this information, hospital rates will skyrocket and the consumers will lose. She adds that outpatient emergency centers, like Access, can be set up to aid those residents in remote areas.
As for Reston's Susan Jones, she says she certainly doesn't want hospital rates to go up.
But she says she thinks the de- bate should go "beyond pure economics. There are a large concentration of people out here, some elderly and low income . . . . We need a full service hospital here."