The Kenai Peninsula Borough Assembly eventually voted down an ordinance that would have moved the boundary between the Central Peninsula Hospital and South Peninsula Hospital service areas, but the debate over the measure highlights an issue that has repeatedly come up: in terms of delivery of health care in the borough, what worked in the past will not work in the future.

The debate over the hospital service area boundary boiled down to fairness over property tax levies. The tax levy for Central Peninsula Hospital’s service area is 0.01 mills, while the South Peninsula Hospital service are levy is 2.3 mills. While it would appear to be fair to pay the tax in the service area for the hospital you’re more likely to use, adjusting the boundary would pose financial challenges for South Peninsula Hospital.

Both hospitals are borough-owned facilities, and it is counterproductive for them to be competing with each other for tax revenue, particularly when the future of health care on the peninsula is likely to include increased collaboration between health care facilities.

There are bigger concerns with the potential consequences on a shift in boundary, namely that the fact that there’s a boundary in place precludes collaboration. That’s the case in Ninilchik, where South Peninsula Hospital provides a physician for the Ninilchik Tribal Council Community Clinic as well as access to lab and imaging services. If the boundary change had been enacted and the Ninilchik clinic were no longer in South Peninsula Hospital’s service are, that assistance could no longer be provided.

While delivery of health care on the Kenai Peninsula has vastly improved since the days when physicians made house calls via small airplane, there are still plenty of challenges, and limiting available solutions based on political boundaries doesn’t help. Looking ahead, the borough’s Healthcare Task Force continues to work on the issue, and assembly members have said they will look into establishing health care powers in the borough, or consolidating service areas.

Changes are likely to be unpopular, as it’s likely that a greater number of borough residents would see their mill rate go up than would see a decrease. But if the goal is to health care delivery more efficient — and providing opportunities for collaboration between health care facilities is a step in that direction — then eliminating a barrier would seem to be a step in the right direction.