It’s a tumultuous time for health care nationwide, and a crowded race for the St. John’s Medical Center Board of Trustees has 10 candidates vying for four open seats.

The board is nonpartisan. The seven-person entity oversees the public nonprofit hospital. Voters can cast their ballots on or before Nov. 6. Learn more about the candidates in next week’s special election section in the News&Guide.

With an eye toward health care access in rural communities, hospitals shutting down across the country and a volatile insurance market controlled by national politics, we asked candidates what they see as the greatest challenges facing health care in Teton County and Wyoming. We also asked them where they see St. John’s Medical Center in five years.

Joe Albright

Greatest challenge: At least 83 rural hospitals around the country have been forced to close since 2010. Hundreds of others are hurting financially. The toll seems greatest in states which did not expand Medicaid. In part that’s because people in rural communities tend to be sicker, older and poorer than those in urban areas. Also, the decline in national demand for inpatient services has hurt rural hospitals.

St John’s in the future: I’m an optimist, so I’ll predict that: 1) We’ll still be getting five-star ratings for quality. 2) We’ll have more employee housing. 3) We’ll have expanded our home health care services. 4) Our price increases will still be less than the national rate of medical inflation. 5) Our new Sage Living nursing home will be a hit with the public. 6) Paul Beaupre will still be our CEO.

Linda Aurelio

Greatest challenge: Jackson’s cost of living. A majority of staff/physicians (63 percent) still live locally, but that will change as the cost of living continues to escalate. We need to continue to create more employee housing opportunities and also focus on transportation. We must work closely with START for dedicated bus services to outlying areas with schedules to meet the work hours of our employees.

St John’s in the future: I see a very good future for St. John’s. We continue to evaluate community wellness, service needs and future trends of medicine in general. We are well-positioned with our attention to quality of care and outcomes. Sage Living will be fully operational for our seniors, and both radiology and surgery services are well-equipped to handle expanding needs as well as our cancer care services.

Joshua Beck

Greatest challenge: I have seen increasing pressure from insurance companies to deny services and payment for health care services. At the same time I have seen health care premiums skyrocketing. I believe cost containment, better quality care and access to healthcare are our greatest challenges today in Jackson.

St. John’s in the future: I hope to see St. John’s providing better, safer and more cost-effective care for us, our families and visitors. I hope to foster an environment of collaboration, respect and excellence.

Kyle Burson

Greatest challenge: Keeping quality doctors.

St. John’s in the future: A better hospital, with quality doctors.

Susan Crosser

Greatest challenge: The greatest challenge facing rural healthcare is the increasing reliance on Medicare. This forces doctors into employment by the hospital in order to share expenses. But, unfortunately, that can lead to problems as well. That is why we need accountability. The board has to oversee the medical staff and protect the community from a doctor that might be trying to extend their reach beyond their grasp.

St. John’s in the future: I think we have to recognize that Medicare will never pay a full share of operating costs, and with an aging population, this will only get worse. I do not agree that engaging in marginal services to make a profit is appropriate. The hospital will need annual donations to help cover the Medicare shortfall. Thankfully, we live in an incredibly generous community with the resources to help in this area.

Joyce Frye

Greatest challenge: Distance and access to specialty services and providers. When I was with the Indian Health Service as a medical student on the Whiteriver Apache Reservation, specialists flew in from Tucson every two to four weeks. Hospital care was provided by family practitioners and the pediatrician. Public health nurses made home visits. We have different needs, but some features of that system could be applied here.

St. John’s in the future: A financially stable institution offering services that are aligned with the needs of the community, including integration of evidence-based complementary healthcare modalities and community-based practitioners.

Liz Masek

Greatest challenge: Prioritization of services with limited resources. The community has high expectations and needs, and we must constantly assess our ability to deliver the highest quality for a very broad continuum of care.

St. John’s in the future: We will continue to be the primary healthcare provider in the region. Part of this care will include the expansion of top-of-the-line surgical procedures, primary care, cancer care, geriatrics and wellness. We will be the epicenter for collaborative relationships to address a spectrum of diseases, including mental health and preventative care.

Chris Schroeder

Greatest challenge: Employee retention. There are many other serious issues, but when you get the right people in the right place, who are passionate about the mission and happy with their outside life, you get stability. While fresh blood and ideas are vital, institutional knowledge and comfort with your “work family” is just as crucial. We spend too much on travelers who have to be trained, and ultimately leave.

St. John’s in the future: Five years is actually a short time in the corporate world. With focus, I hope for a coordinated health care cooperative in the greater Teton valley, with St. John’s at the head, but supportive of, and being supported by the other entities. I hate to use corporate buzz words, but we are losing the potential synergy that the diversity of providers we have to offer.

Geoffrey Skene

Greatest challenge: Our biggest challenge is maintaining quality, consistent staffing in the face of the ever-increasing cost of living and housing in our community.

St. John’s in the future: I hope to see St. John’s continue to grow and offer ever-improving technologies and specialized care while continuing to expand patient options, reducing cost and improving outcomes.

Michael Tennican

Greatest challenge: Finances. Unlike specialized profit-seeking facilities, rural hospitals typically provide numerous community health services that don’t cover costs. When rural hospitals lose patients for services (primarily surgery and imaging) that can generate offsetting profits, they are in an unsustainable economic position. Many are closing or converting to limited-service satellites of urban hospitals.

St. John’s in the future: The fundamental change will be in St. John’s’s ability to provide long-term care to citizens with cognitive disabilities. St. John’s will monitor other community health and wellness needs and selectively add services and technology. I also expect significant progress in meeting staff needs for housing, particularly for the many staff members that provide critical services and must live close to the hospital.

Contact Kylie Mohr at 732-7079, or @JHNGhealth.

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