Last month Sutter Coast Hospital CEO Mitch Hanna denied a request from the Del Norte County Healthcare District to provide information about the criteria the hospital uses in its billing practices. In a letter to the district Hanna justified the decision by saying that the information “might be misinterpreted and somehow used to besmirch our reputation in the community as has so frequently been done in the past.”

After several years of conflict between the hospital and the district, the relationship between the two has become stuck in an adversarial rut. At a time when the medical community is struggling to bring needed specialists to the county and needs to be united in its efforts to rectify the situation, this conflict may be doing more harm than good for Del Norters and our neighbors to the north.

That being said, the hospital’s refusal to explain their billing practices is inexcusable. Blaming the Del Norte Healthcare District for how it might characterize the information is a cop out. If the hospital has nothing to hide, what worry does it have of its reputation being besmirched — regardless of who might do the besmirching? This is a serious issue to Del Norters, who depend on the hospital for essential care but often face crippling bills as a result, and it is beneath hospital administration to wave away this request by scapegoating the Healthcare District.

To the extent that Sutter Coast’s reputation is less than stellar, it has only itself to blame. Its attempt to dissolve the local hospital board and transfer local ownership to Sutter Health was widely perceived as a naked power grab, paving the way toward an alarming attempt to reduce its beds to an unacceptable level for properly serving the needs of the area.

The Healthcare District was instrumental in keeping the heat on Sutter Coast to back down from these worrying moves, but the question needs to be asked whether it is in the best long-term interests of the county for the two bodies to remain adversarial when other issues are at stake that only they can solve together.

This does not mean letting Sutter Health off the hook for any current or future questionable practices. It means that concerned citizens need to stop putting the Healthcare District in the position of acting outside of its responsibilities and putting it at odds with the hospital.

One of the more remarkable aspects of the adversarial relationship between the district and hospital is that the district does not have any authority to provide oversight of the hospital. Simply put, holding Sutter Coast accountable is not within its duties. Yet that has become its de facto role since the hospital board several years ago attempted to transfer local ownership to Sutter Health. At the nadir of the dysfunctional relationship, members of the Healthcare District Board even considered spending $50,000 in public funds on an ad campaign against the hospital to blast it for alleged greediness. This is not the way forward to solving issues like bringing more physicians to the area.

The county’s best interests are what’s at stake, and both sides need to make an effort to accomplish that.

For its part, Sutter Coast needs to be transparent and responsive to the community so that the Healthcare District doesn’t need to be a voice of public concern.

Sutter Coast has made some encouraging moves. They have not traded away local ownership of this hospital and they ultimately halted their efforts to become a “critical access” hospital. And they are to be commended for their recent move to replace Envision Healthcare emergency room doctors, which were costing patients exorbitant amounts.

But more can be done, and their defensive attitude about discussing their billing practices does nothing to improve the public’s trust nor does it help the hospital’s reputation. Additionally, its board meetings should be open to the public in the interests of transparency and accountability. One wonders why the hospital wouldn’t prefer to cut out the middle man of the Healthcare District and let the public bring its concerns about the hospital directly to them and to leave no room for suspicion about its decision making and practices.

On the Healthcare District’s part, it needs to redirect its constituents complaints about the hospital to the appropriate agencies and people who can exercise authority over the hospital.

Who, then, can fill that role? The California Department of Health Care Services oversees the hospital’s medical services, and the California Department of Public Health oversees its licensing. Additionally, locals who feel they are getting nowhere with the state bureaucracy may wish to appeal to their state legislators for leverage. State Sen. Mike McGuire has made concerted efforts to visit Del Norte and listen to his constituents here, and Assemblyman Jim Wood is himself a physician who has taken on a prominent role in crafting state health care policy.

Of course, working with state agencies and legislators are inevitably slow processes. There still needs to be some local body that can fill a watchdog role and respond in detail to concerns about Sutter Coast that members of the public feel aren’t being addressed while at the same time shielding the Healthcare District from an adversarial role. While it has made sense in the past for that to be the Healthcare District, whose members have intimate knowledge of health care in the county, others need to share the load so the district can rebuild trust with the hospital, enabling them work together on issues within the district’s purview. The county board of supervisors is best positioned to fill that role. In the past it has tended to take a backseat to the Healthcare District, but moving forward it needs to take the lead, and members of the local medical community who do not serve on the Healthcare District board should be advising them.

We believe that it is only by shifting from the Healthcare District some of the burden of keeping the hospital accountable to its patients that we have the best chance of improving overall medical care in the county. Everyone — Sutter Coast, the Healthcare District, citizens and county leaders — has a role to play in making this happen.

Unsigned editorials are the opinion of the Del Norte Triplicate editorial board, which includes Publisher Kim Fowler, Editor Robin Fornoff and Managing Editor Matthew Durkee.