The extensive letter from Butler Health System CEO Joseph Stewart published in Sunday's Butler Eagle was a welcome return to public discussion about the future of Butler Memorial Hospital. For such an critically important topic, there is been too little communication and openness between hospital officials and the Butler County community.

Regardless of one's position on the current plans by hospital officials to build a new hospital on a new site, the debate over Butler Memorial Hospital should be followed closely by people throughout the county because it will have a profound effect on healthcare and, potentially, healthcare costs for decades to come.

Many people in the community are still conflicted over whether the hospital should (or can afford to) build a new hospital on a new site - or whether a new hospital should be built on the current East Brady Street site. Working with the current location would probably mean building a new multi-story hospital building and then using the 1980 "Main Building" and the tier garage, while tearing down all of the older structures.

Regardless of the decision on building a new community hospital for Butler County, the process should be more open than it has been. Though hospital administrators and members of the board of trustees might not appreciate the interference from the public, there should be input from outside the hospital's boardroom. This is a community hospital after all. Opposing views are healthy and can help produce the best outcome.

Pressing forward with what appears to be a pre-determined plan while dismissing or demonizing those who disagree with that position is not productive.

Stewart's letter provided no new information, but it did a good job of outlining his (and the trustee's) position that a new hospital must be built somewhere other than the current hospital campus.

In supporting that argument, Stewart mischaracterized the alternative plan as simply a renovation that would result in using "an older building added onto and patched together over the years."

That is not what proponents of working with the current campus are proposing. But details of just what that proposal would look like have not been put before the public because hospital officials have never seriously considered the possibilities of working with the current site.

The hospital's rejection of the Butler Eagle's offer to pay $50,000 for a more detailed study of what could be done at the current site suggests BMH officials don't want the public to know that there is a viable alternative to building on a greenfield site - on the VA campus or elsewhere.

A better approach would be to allow that study to be made and presented to the public, then Stewart and others could point out what BMH officials believe to be fatal flaws and explain why they believe such an approach would not work as well as building elsewhere.

It's easy to discredit an idea that has not been publicly presented, and can therefore be mischaracterized. The members of the board of trustees, as representatives of the public, should be obligated to making sure that all alternatives have been fully explored. But that has not happened.

What harm can there be in learning about alternatives to the board's current objective to build on the VA campus or elsewhere? By allowing the study to be done, the board might silence some of its critics and demonstrate to the community that it is fulfilling its fiduciary responsibility to investigate all reasonable alternatives in balancing the community's healthcare needs with the hospital's ability to pay.

In a perfect world, the hospital would have $200 million or more to spend on a brand new facility. But the reality is that the hospital, like most people buying a home, has budgetary limitations. And there must be compromises and choices made to get the most hospital for the money.

In his letter, Stewart wrote that to proceed with a study of the current's location's possibilities would be "a waste of time and money." But whose time and money? The internationally respected architectural firm of Burt Hill Kosar Rittelmann would do the study and it would be paid for by the Butler Eagle, with the possibility of additional contributions coming from other members of the community interested in making sure that the best decision is made concerning the hospital's future.

Any communication from hospital officials is welcome. An open, two-way dialog with the community would be best. Still, Stewart's letter should be helpful in stimulating more debate about this extraordinarily important topic. Everyone in this county has a vested interest in learning more about this debate and making sure the best decisions are made.

- J.L.W.III