As a candidate for commissioner of the proposed public hospital district, I read Sheri Reder’s article (“Proposed Hospital District: Fix Flaws First,” Sept. 12) with interest. She raises good points, but I disagree with some of her assumptions.

An increase in taxes beyond 1% of the base rate is only possible after a detailed budget is prepared with rationale for changes and public hearings with community input. Voters’ input matters.

Emergency medical technicians and paramedics are wonderful first responders. They stabilize and transport patients in an emergency. However, they are not licensed to function as independent medical providers. Additionally, their services come at a cost. VIFR’s 2019 budget is approved for $200,000 in transport fees. With no clinic on the island for minor urgent care, that cost will likely increase.

Telemedicine is a valuable tool in remote settings. However, it does not substitute for the ongoing patient–provider relationship, replace the careful assessment of a tender abdomen or an infant with a fever.

We are unlikely to get the Legislature to create a change to hospital district laws that are already implemented in 58 Washington communities. Special legislation is unlikely when there is already an established solution.

A public hospital district is the best and only tool we have right now to start fixing the flaws in our current system. Electing responsible commissioners to create a community medical clinic is how Vashon residents have a voice in their own local care.

— Wendy Noble, ARNP