A few days ago, as the lengthy debate over a proposed bond issue for a new Wishard Hospital neared its end, the writer of a letter to the editor of The Star pointedly asked why such an essential institution even had to be put through the drama of an election.

There are reasons, of course. State law newly requires referendum approval for projects paid with revenue bonds — that is, backed by taxpayers — and Wishard’s leaders chose that type of bond in order to secure a low interest rate.

Furthermore, even though no tax increase is called for in the construction plan, it entails a $754 million expenditure on a public amenity, which makes it the public’s business.

Still, the correspondent’s lament is well taken.

Conseco Fieldhouse and Lucas Oil Stadium, like Market Square Arena and the RCA Dome before them, actually did increase the tax burden on local residents; and nobody gave them a chance to vote on these entertainment venues. There was no talk of a referendum when the “older” facilities were torn down and replaced after about 25 years.

At Wishard, 25 years would be yesterday. The conglomeration of 17 buildings in which the hospital carries on its vital and outstanding work dates to the early days of the last century. Space is claustrophobic. Equipment and personnel spill over from patient rooms into narrow hallways. Wiring, ventilation and plumbing break down routinely, and can’t be modernized within the physical confines of the ill-fitting bundle of structures. Care takes too much time and costs too much money.

Without a new Wishard, says CEO Matthew Gutwein, care will cease. If that sounds alarmist, it is worth noting that no credible challenge has been raised to his assessment of the hospital’s deterioration. Nor have opponents of the bond issue cast serious doubt on the no-tax-increase pledge. Generally, they have stipulated to the necessity of the county’s public hospital and then expressed vague suspicion about the possibility of new taxes. New taxes for health care, in other words, rather than stadiums and arenas. Opponents have not advocated such a thing; but it would be the reality of a “no” vote in today’s special election.

In effect, those who would deny Wishard permission to remake itself for the 21st century are begging the question. Marion County voters today must answer them by doing as the city’s civic, business and religious leaders have done, and answering yes to one of the most critical questions they will face as a community.