Scotland Health Care System is fiscally sound even as other smaller hospital systems are being bought out, the system announced Thursday.

However, the leaders of Scotland County's healthcare community worry about one major change that is coming up.

The biggest issue looming over Scotland Health Care System isn't the rising costs of medication, recession or high regional unemployment; instead, top administrators worry most over the possible consequences of legislative health care reform.

Greg Wood, president and CEO of Scotland Health Care System, said without any reservations that the need for healthcare reform was real.

"In a country as successful as our nation is, we don't need to have 17 percent of the people without insurance," Wood said. "The biggest advantage in the health care package now is it will get 95 percent of people covered. It will allow people to get the primary care and the preventive care they need as opposed to them waiting until its too late and coming to emergency centers around the country."

The primary costs of this reform won't be saddled on the backs of taxpayers, however.

"In order to fund that, the providers – the physicians and hospitals – will have to take a payment cut in order to provide that additional coverage"

"The biggest challenge, without a doubt, will be to continue to deliver the high quality health care and service that we render as our reimbursement, particularly for medicare and medicaid, get reduced," Wood said. "... It may result in less patients in our emergency center, but it will also likely result in lower payments from Medicare."

Craig Ellis, vice chairman of the systems board of trustees, told those who attended the meeting that revenues for the hospital increased by 11 percent, even as Scotland County consistently ranked first in the state for unemployment and second for poverty.

Chairman Jim Mason remembered the concerns of the local healthcare system going into the community meeting last year.

"Last January, the worldwide financial crisis was taking a toll on us," Mason said. "We struggled financially through the end of 2008. We wrestled with the value of our independence as a hospital versus the advantages of joining a larger system. We also began to prepare for the H1N1, or Swine Flu, pandemic and its predicted chaos."

"Fortunately, we had an extraordinarily successful year, far beyond our expectation. Finishing the year in a solid position allowed us to improve critical clinical services and technologies... We also began a major project to improve the appearance of our patient rooms, along with our external and internal environments. Most importantly, our financial success allowed us to continue to recruit high quality staff and physicians."