"Consolidation" is a term that many industries have come to know - both in definition and reality - in 2009. Barnwell County itself has felt the positive and negative effects of the double-edged sword of consolidation. Consolidation has shuttered some of the county's plants and dissolved local jobs, such as with the Hanesbrands and Allied Air factory closings.

Yet as we have felt that sting of disappointment, we have experienced the glow of anticipation when Crane Corp. announced that it would be nearly doubling its Dixie-Narco plant.

There is another type of consolidation that could happen to Barnwell and its neighboring counties.

This is the consolidation of medical capabilities in Barnwell, Allendale and Bamberg counties. The idea is to establish a regional hospital among the counties where each county would share in the expense of maintaining it, hopefully at a lower cost to each county than what they are paying to sustain their own respective facilities.

The idea has merit, but is also fraught with many details that would need to be hammered out between the leadership of the three counties.

The concept of a regional medical center is not new. The idea surfaced several years ago, but resulted only in discussions without any real decisions made.

It may be time to revisit the idea in earnest again, especially since healthcare costs are rising in general. Also Barnwell County Hospital, like many facilities in areas with high indigent care, struggle financially.

Recently, the Barnwell County Hospital was given approval by the Barnwell County Council for a line of credit for the hospital. The County Council gave approval for the hospital to try and obtain a $1.6 million U.S. Department of Agriculture loan through the S.C. Office of Rural Health to help its finances.

Also, there have been informal discussions of selling the county hospital to a hospital company to run it.

The devil, as the old saying goes, is in the details.

There would be many agreements that the three counties would need to work out, the primary one as to where to locate the regional facility.

It is almost a foregone conclusion that in all three counties, 24-hour urgent care medical clinics would needed to stabilize patients before transporting them to such a regional facility.

The challenge for each county would be that if a regional hospital were to become reality, what would be done with the existing hospital buildings?

One idea is they could be the site of the urgent care clinics. Also, each of the three counties have more of one particular medical specialty than their neighbors. Possibly these could be housed in the vacant spaces left after a regional facility has been established.

Consolidation, whether in industry or other enterprises, is usually done to make things more cost-efficient.

In these tight economic times, cost-efficiency is becoming the modus operandi of many endeavors.

It would be worth the time for the leaders of these counties to open a new dialogue on this topic because tighter budgets now would give it more of an emphasis and perhaps make the idea - if not appealing - palatable.