The debate over whether to build a hospital in West Des Moines has had all the feel of a primary cycle in an election year. It has been long, drawn-out and bloody. And we’re nowhere near November.

Iowa Health-Des Moines, led by Chief Executive Eric Crowell, has a month to decide whether it will appeal the Iowa Health Facilities Council’s rejection of its plans to build the $82 million Michael R. Myers hospital.

Iowa Health officials should let the deadline pass without taking action. The defeat was painful for those who came to believe in the need for a new hospital. Tears fell as the verdict was read.

The open emotion is understandable and it will take time for it to subside, which is why I think Iowa Health executives should wait. In the meantime, they can learn from their missteps.

First, Iowa Health failed to understand the growing frustration and anger — across the nation — at the cost of health care. It’s coming from employers and workers alike. Forget about the reasons for now. They’re far too complicated to get into here. What matters is the bottom line. Health care is eating up profits and cutting into workers’ paychecks.

A new hospital might lower costs in the long run, but explaining how that’s going to happen (assuming it’s true) will take far more transparency and communication than Iowa Health has delivered so far. Meanwhile, folks are scared and mad. Iowa Health’s opponents exploited the opening.

Second, Iowa Health underestimated the lengths to which its opponents would go in the debate. In most fights, the guy who hits first and hard wins. In this case, Iowa Health was at an even greater disadvantage because its chief opponent, Wellmark Blue Cross and Blue Shield of Iowa, is unusually influential and led by a man, John Forsyth, who spent more than a decade running one of the nation’s most prestigious hospitals. He knows the game, maybe better than anyone else in Iowa.

Lastly, Iowa Health executives failed to grasp the simmering rancor between the western suburbs, which rightly or wrongly attract the lion’s share of attention and investment in Central Iowa, and the rest of metro Des Moines.

The easiest way to look at the issue is to compare it to an election with two candidates on the ballot: one who favors the hospital and one who doesn’t.

The anti-hospital candidate, portrayed by Forsyth, played his hand well. He stuck to one issue — cost — and hammered it home in the newspapers, in direct-mail pieces, on the Internet and elsewhere.

The pro-hospital candidate, represented by Crowell, spent much of his time on the defensive or trying to change the focus. He denied accusations that costs would rise one moment, then argued that his hospitals are overcrowded the next. He pointed to an array of issues to defend or support his case, including use of philanthropic dollars, the growth of the suburbs, federal health-care mandates, the need for private rooms, and the difficulty of delivering modern care in 100-year-old buildings. All of these factors may be true, but they’re tricky to absorb.

The analogy is useful because I believe Iowa Health’s executives are (rightly) attuned to delivering health care. They’re not political animals. But this was an intensely political debate.  In the end, it was the sheer volume of the public outcry (more than 5,000 letters) that locked up the system. The members of the Iowa Health Facilities Council, who have never before seen such opposition to a hospital proposal, retreated to the only safe option they had.

They know Des Moines’ western suburbs will grow. They know the two candidates will eventually agree a hospital is needed. When that happens, the council will be ready with the stamp of approval – but not a moment sooner.