The only sure thing about a new strategic alliance between Valley Medical Center and UW Medicine was the 3-2 vote to set it in motion, at least in Renton.

There was absolutely no doubt in my mind that the alliances would hold firm, that commissioners Anthony Hemstad and Aaron Heide would stick to their agendas and vote no.

They fashion themselves as reformers. Frankly, I am not quite sure what problems they want to fix. Valley Medical Center is an award-winning institution and financial and procedural auditors routinely like what they see.

Yes, Rich Roodman makes a lot of money, but he’s worth it. That is an old story and I have nearly 30-year-old archives on my desk to prove it.

Yes, that “stealth” annexation years ago was a mistake. But no one dare say that the lead up to Monday night’s vote was done out of view or under the table. Whoever heard of a public body openly discussing a contract and its position, in full view of the other side?

No agenda should flow from those two issues.

Frankly, the problem rests with the Board of Commissioners for Public Hospital District No. 1. It’s broken – hopefully not beyond repair. Other elected boards can disagree vehemently, but at least they find a way to compromise and get the public’s work done.

Valley’s board had to bring in a parliamentarian to keep order at its meetings. I am not joking, but maybe it needs to hire a workplace psychologist to help the five commissioners figure out how to respect and trust each other.

More than ever, these five people – and that includes Carolyn Parnell, Sue Bowman and Don Jacobson – are going to need to work together to protect the public’s interests – and assets – in this brave new world of a 13-member Board of Trustees that will oversee the day-to-day operations of Valley Medical. The five will sit on that board.

At the beginning of this column, I referred to the “only sure thing.” What’s not sure is how the alliance will play out, even though the agreement is carefully crafted. There’s a hint (and it’s a good one) within UW Medicine and its other “children,” such as Harborview. But the agreement with Valley is unique. Valley negotiated from a position of strength. It’s not a junior partner. Its “own” voice must be heard.

I am not saying the “old” and “new” trustees will inherently have an adversarial relationship. I am saying that Valley’s five-member elected board will serve two masters, the public and the alliance itself. They need a common vision for how they will serve the public. That won’t come from an acrimonious relationship. If not, Heide and Hemstad could find themselves marginalized on the larger board.

All I am asking as a resident of the hospital district is that you work together. That you set aside your differences. That you set aside those issues that simply have nothing to do with providing quality health care for me and my neighbors.

The prize is worth it.

In my view, the alliance is a good idea, with its goal of improving the health of Southeast King County residents who can or can’t afford access to quality care. But, I had reservations, if that really matters.

I don’t want to see Valley Medical Center lose its identity. Valley became a top-notch medical facility not because of any support from Seattle, but from the support and tax dollars of residents of Renton, Kent, Tukwila, Auburn, Covington, Newcastle and even Bellevue.

Go ahead, call me provincial. At least I took a giant step to get over it during the positive vibes from the audience testifying at Monday night’s commission meeting. Parnell, Jacobson and Bowman clearly deserved the applause for voting yes and later praise that was heaped upon them. Heide and Hemstad missed that; they left right after the vote was taken.

Nor does it bother me that non-elected trustees, some from out of the area and all appointed by the UW, will serve on the new 13-member board. Some big-name hospitals – UW Medicine, Harborview and Swedish – all have boards appointed in some fashion. After all, hospitals are run by medical professionals, not politicians.

The debate did get sidetracked by what I once referred to as red herrings.

But what’s important is patient care. What’s important is that we in Southeast King County will benefit from the talents and teachings of UW Medicine. In turn, UW Medicine will have the room and the patients to grow its own medical and teaching programs.

When it comes time this fall to replace Don Jacobson on the board, voters should remember what this historic strategic alliance is all about – patient care and safety. Anything else is just a red herring.

Finally, I would respectfully encourage the trustees of UW Medicine and the regents of the University of Washington to approve the alliance. It’s to your advantage. In my view, Valley Medical Center will make you stronger.

(Watch the meeting online)