Last week, nine islanders stepped forward to help right the listing ship of Vashon’s health care. They are candidates for the five commissioner positions for the proposed public hospital district, and we expect to hear a lot more from them in the upcoming months. While they come from a variety of backgrounds, they have a common goal — to determine what islanders need for local health care and how to make those services possible for the long term. They each deserve our thanks for their willingness to address this complicated issue and their willingness to serve.

This November, we will vote on the creation of a public hospital district at the same time we vote for the commissioners. The district would support island health care, but not fund an island hospital. The island has voted on creating a hospital district three times before, once in the 1930s, in 1949 and in 2006, when it was soundly defeated.

It might seem like an unusual idea to many of us — to tax ourselves for community health care — but hospital districts are common. Across the state, 58 communities have established them. Forty-four have hospitals, and the remainder provide other health care services, according to the Association of Washington Public Hospital Districts.

We have arrived at this place, possibly joining those nearly 60 other communities, because health care on the island has been financially fragile for decades, if not for its duration. Many islanders know this reality well, as providers have come and gone, citing financial losses. And were it not for Neighborcare Health, we likely would not have a clinic at Sunrise Ridge at all. But last summer, Neighborcare CEO Michael Erikson announced that the clinic was losing $350,000 annually and that community support would be essential. Thanks in part to the work of members of the Vashon-Maury Health Collaborative, who worked to find a replacement provider after CHI Franciscan left, we know that providers such as the University of Washington, Swedish or Multicare will not come to our rescue only to lose money.

This choice — whether to help fund local health care through tax dollars — is just one of the many ways the island is at a crossroads currently, and it is essential that islanders be part of the health care/public hospital district conversation in the coming months. It is important to remember this decision is not about Neighborcare, which may or may not be part of a solution going forward, but about health care as a whole.

This fall, we need to ask hard questions about a hospital district itself and seriously consider their answers. And we need to ask hard questions of the candidates to understand how they would steward our tax dollars and make decisions. Of course, no islander would be excited about another tax, but the alternative is also deeply troubling. Access to health care is vital in every community, and losing the Sunrise Ridge clinic would have far-reaching effects on the island.

With this election and the campaign leading up to it, we are all being called to the table for a conversation about health care. Let’s all gather around that table, with open minds and thinking critically, and make choices for the good of the island.