Today, if you have a concern about the quality of medical care at Inter Island Medical Center, you can take your concerns up with your elected board of commissioners. They work for you. You can talk about issues of concern at public meetings. If you are not satisfied with a commissioner’s performance, you can vote for change at the ballot box.

In the future, if you have a concern about the quality of medical care at the new integrated medical center operated by PeaceHealth, you can take your concerns up with … well, that’s not clear. Your commissioners will have no authority over the new medical center, although they have the authority to hand over your health care to PeaceHealth, without your vote.

The integrated medical center will be overseen by a board appointed by PeaceHealth. The board will be comprised of a majority of island residents. But the board will report to PeaceHealth Whatcom, which in turn reports to PeaceHealth. The board will not be required to have public meetings because it is a private, not public, organization.

This troubles us almost as much as the blinding speed by which this project is moving ahead. The board of commissioners is expected to sign the contract in March. At that moment, with the stroke of a pen, with or without your consent, your medical care becomes the responsibility of PeaceHealth, not the medical district you created — until the year 2060.

Don’t get us wrong. We see the need for an integrated medical center on the island. But we believe the public should have a voice when it comes to the quality of medical care it receives. The solution: A member of the board of commissioners should serve on the local PeaceHealth board and meetings should be public.

In fact, we’d argue that they are required by law to be public, since the PeaceHealth board will act on assignment by the current board of commissioners. In other words, the current board of commissioners will sign a contract assigning the provision of medical services to another organization. And PeaceHealth will receive our property taxes to help pay for the hospital’s operation. That sounds “public” to us, not unlike the County Council assigning responsibilities to a county board, committee or commission.

PeaceHealth and proponents of the integrated medical center have done an admirable job of addressing earlier concerns raised by residents, and reportedly resolved those concerns in the contract that is being developed for the board of commissioners’ consideration next month. One concern was the former requirement that the hospital district bond for a third of the construction costs.

This is also big: A member of the board of commissioners should serve on the local PeaceHealth board and meetings should be open to the public.