HoodaThunk?

At the tail end of last week I got the weekly crop of local newspapers and something in one of them caught my attention. It was a full-page ad sponsored by Inova Loudoun Hospital that purported to do a side-by-side comparison of HCA’s proposed Broadlands hospital project and Loudoun County’s Health Plan - which just so happens to include a location for a southern Loudoun hospital precisely where Inova’s proposed new hospital would be built.

A coincidence, I’m sure. But that’s a topic for a later conversation.

The ad (you can see a scanned-in copy in PDF format here - warning: it’s a big file so give it time) goes into some editorial detail into how Loudoun’s Health Care Facilities Policies were developed and specifically mentions Inova’s efforts in bringing quality healthcare facilities to all of Loudoun’s citizens. Admirable. The accompanying map shows a geographically dispersed set of facilities with the current Lansdowne and Leesburg facilities as well as the one in the southeastern corner of Loudoun that’s being proposed. The other side of the ad shows the HCA Broadlands approach, complete with a map showing the proposed location and it’s relationship to existing facilities. The text of that side of the ad basically attacks the entire idea of putting a hospital in Broadlands. What struck me almost immediately were the nearly frantic claims being made that even considering HCA’s plans were putting the entire healthcare system in Loudoun in jeopardy and the clear attempt to paint the entire project as some kind of evil corporate plot to… well, I guess to provide us hospital care.

Before I began to do the research into the only argument of merit - that Loudoun’s population didn’t support having that hospital there - I was struck by some of the obvious manipulations going on. Have a look at those 2 maps closely. What the map of Loudoun’s facilities plan is clearly showing is a plan to distribute the facilities geographically. That’s all well and good - if your population is evenly distributed geographically. The critical issue about the population isn’t a matter of how many people there are - which is important, don’t get me wrong - it’s a matter of where those people are. In other words, it’s a matter of the population density and how many people are clustered around specific points in the county. The map of Loudoun’s facilities plan doesn’t take into account the locations of highest density. It merely spaces the facilities out around the county. That’s not useful in a real-world sense.

Now have a look at the other map, the one that shows the proposed location of HCA’s hospital. It’s so subtle, I’m betting you don’t even notice it. The center of the star showing the HCA location is actually to the north side of where Route 267 (the Greenway) runs. That’s not where the HCA location is. It’s to the south side. The impression given by moving that star just a hair to the north and east is that it’s closer to the Lansdowne facility than an actual siting on the map would convey. Ah, but that’s not all. Note the location of the Lansdowne “H” on the map on the left side, the one showing Loudoun’s facility plan. Take special note of the distance that icon sits from the Route 15 loop around Leesburg. Now compare the same distance in the map on the left right. It’s shorter. You can see that when the map was drawn, the icon was “pegged” to the word “Leesburg” above it. Compare the positioning of the word “Leesburg” and you can see easily that it’s been shifted leftward. The Lansdowne icon in the HCA map has been moved slightly to the west - closer to Leesburg. Combined with the slight move north and east of the star representing the HCA location you’ve closed the distance between those 2 indicators on the map, yielding a much stronger impression that the 2 sites are nearly on top of each other. Was this intentional? I have no idea but I do know that I can’t think of a good reason to move that icon. The two maps are supposed to be identical with regard to Loudoun’s borders, roads, and the location of Inova at Lansdowne. Presuming that the person preparing that graphic didn’t start from scratch when they made the maps, you’d think they wouldn’t move stuff that didn’t need to be. I make graphics similar to this all the time in preparing the documentation I do for customer projects and I know I make use of as much of previous documents as possible and I work very hard to make comparitive diagrams match as much as can be done. Is this evidence of manipulation? Again, I don’t know.

Getting to the text, the claim is made that the HCA site is in a “residential neighborhood within 5 miles of the existing hospital.” Well, I don’t want to quibble on the distance but my quick Google map check shows it to be right at 5 miles. Using the term “about 5 miles from the existing hospital” would have been far more accurate and less prone to leave a mistaken impression in the mind of the reader. Assuming that’s what you want, of course. I should like to reitterate that the argument that the 2 facilities are too close to each other based upon a mileage measurement missed the point. Out-of-state members of my family are always complaining that when they ask how far I live from some point out here, I always reply in terms of minutes. I answer them that it’s a question of how long it takes to get somewhere that’s important, not how many miles go under my tires. I can be 10 miles from something out here and have it take an hour to arrive. I can be 25 miles from other stuff that I can get to in 30 minutes. Where a hospital is concerned, I care about how long it takes me to get there, not that it’s 12 miles from me. Mere physical distance should not be the deciding factor in whether it’s too close. It should be population density and transit ability that decide.

As far as being in a “residential neighborhood” I would point out that many, many hospitals are “in” residential neighborhoods. Besides, if you look at my original post on this matter and follow the location link I provided, you can see that the site is bound on 2 sides by highways, not residences, and on the 3rd side abuts to the LCPS administration building. All of the residences are across Broadlands Blvd, a 4-lane, divided parkway. This is hardly nestled in between private residences as the text implies.

Then there’s the claim that putting this hospital in Broadlands will “force the closure of planned and existing healthcare facilities in Leesburg, Lovettsville, Purcellville, and Middleburg.” That’s gotta be the biggest whopper of the bunch. Putting said hospital in Broadlands will kill off all of those things but putting it down where Inova wants to build theirs won’t? Preposterous. If the population density in Middleburg or Purcellville can support a medical facility then one will be built, period. If it doesn’t, then it won’t. I contend that those places most certainly can support medical facilities of an appropriate size and the population growth that is coming - at one speed or another - will increase that support level as time goes on. Ashburn can support additional facilities right now, today. To suggest that we not build in their community today when the need is clearly there so we can maybe build one in an outlying community years from now when their population supports it makes no sense whatsoever. Same with the claim that a hospital on Route 50 would no longer be possible. Sure it will - if the population density reaches the level to support it. Are they really suggesting that if the Dulles South area reached the same density as Sterling/Countryside that you couldn’t support building a hospital there? Nonsense. Although, given the current board and the activities of the various no-growth folks in Loudoun it’s going to take longer to get there than it would have otherwise.

I started to search for population density figures in the area and do all manner of other research when it hit me: this ad isn’t targeted at the government. This is a matter that’s in litigation, not a resolution to be passed by the General Assembly. Who, exactly, is Inova talking to when they say, “It’s time to tell HCA that enough is enough.”

The only possibly effective target to that ad is the judge in the case. Any why would they be taking an ad out to do that? Because, quite simply, they know the likelihood of HCA prevailing in the case is higher than not. Why is it higher and why does Inova clearly believe that? Because HCA’s case must have merit. My perception is that Inova knows that, too.

We have a neighboring county whose healthcare facilities are a mix of Inova and HCA. They are located similar distances from each other. And they’re working just fine. Inova doesn’t like sharing the customer base, I get that. That’s not a compelling reason to side against HCA and allow Loudoun to go another 5 years without the available hospital facilities our population obviously supports. I hope HCA prevails and can get started building that hospital quickly.