Editor: Two weeks ago the Ballard News Tribune reported on plans to convert the Swedish Ballard campus from a full service acute care hospital to a "comprehensive ambulatory center with low intensity inpatient services." This would be a major change for the hospital and for Ballard.

Here is the situation as I understand it. So-called day surgery would continue to take place at Ballard, but procedures involving more than a few nights in the hospital would be done at other facilities - presumably First-Hill or Providence. Consequently, the Intensive care Unit (ICU) at Ballard would no longer be needed. The emergency room would stay, but only as an urgent care center. Critically sick patients who are now directly admitted from the ER to the hospital would be transferred elsewhere. The Transitional Care Unit (TCU) would also be gone. On the other hand, the childbirth center will be improved and expanded. Different programs yet to be determined would be offered at Ballard, but the full service hospital we have come to rely on for a little over fifty years will be gone.

Again, as I understand it and I'm paraphrasing here, Swedish says this change is necessitated by operating losses at Ballard, a change in demographics (more young people but not enough older people to support a full service hospital), a long term projected population growth of 1 percent for Ballard (meaning fewer patients), and increased competition from other providers of medical services.

Very few people would deny that running a financially stable medical center is a truly challenging job. The hospital business is very competitive. However, before accepting the need to eliminate the full service emergency room and in-patient services at Ballard, I think the community needs to think about this very carefully and ask a few pertinent questions.

We have all heard the figure of a five million dollar loss at Ballard. It has been suggested that much of the loss may be coming from the TCU. It has also been suggested that over half of the patients in the Ballard TCU have been referred from the Swedish Medical Center on First Hill. If this is true, then the "loss" has been transferred to Ballard along with the patients. In addition, there appears to be some suspicion that the more lucrative procedures and activities have been moved to or concentrated at First Hill, leaving Ballard with a diminished bottom line. I am not in possession of all the facts, but I do believe that in view of what we have heard so far, there is sufficient reason to ask for further clarification.

Jody Haug of the Ballard District Council has questioned the low population growth figures that Swedish has cited as evidence of insufficient numbers to sustain a full service hospital in Ballard. Anyone who has paid attention to the results of the neighborhood planning process knows that there has been plenty of growth in this urban village of ours - with more to come. The growth is not limited to central Ballard, it is occurring all around us. The 1 percent figure simply does not tell the whole story.

We should be very alert to age-based demographic blocks. I seem to recall that in the summer of 2004 when Swedish and Northwest Hospital were considering a merger, Swedish was of the opinion that population statistics showed insufficient numbers of young families in Ballard to justify obstetrics and child birthing facilities at Ballard. For this reason, obstetrics and medical/surgical were to be moved to Northwest. It appears that Swedish later discovered that there were indeed many young people moving into Ballard and that child birthing could and should stay here. Unfortunately, we now seem to be hearing that there aren't enough old people to support in-patient services.

Experienced real estate people tell me that most of the new town houses and condos are being purchased by young people, not "empty-nesters" buying down. And yes, the elderly (over seventy) are currently declining as a population block. However, the baby boomers and 50-somethings won't all be leaving Ballard. As they age they will become the new elderly and I think many will choose to remain in this crowded but convenient community. If this comes to pass, and I suspect it will, there would be a sizable population in need of medical and hospital services. Given the past record, something may be seriously wrong with Swedish's current interpretation of census data and we should encourage a re-evaluation.

I have recently talked to many people about their views of Swedish Ballard and the majority prefer to retain the current level of emergency and in-patient services. I would like to think that most of the community shares this view. It is now up to us to communicate this to Swedish and show them that we support our hospital and doctors. A full service hospital is an immensely important asset to the community, both in economic and medical terms. Let's not lose it.

Eddy Harrison

Ballard