Healthcare Focus: Hospital merger: bigger not necessarily better | News

Should the University of Minnesota Hospital be owned by Sanford?

No.

Should the M Health Fairview system be taken over by Sanford?

No.

M Health Fairview includes the University of Minnesota Hospital and 10 other Fairview Hospitals in Minnesota. Sanford Health has 47 hospitals in South Dakota, North Dakota and Minnesota; and proposed a merger of the two systems last November.

As a Minnesota family physician I am convinced the Sanford take-over would be bad for Minnesota patients and physicians.

Let me first address the problem of the University of  Minnesota Hospital. Most doctors in the state are trained at the University of Minnesota Medical School and the University of Minnesota Hospital. The Medical School and Hospital have been leaders in U.S. medicine for years.  Ground breaking work has been done here in many areas — including kidney transplantation and heart surgery. 

Training medical students and residents does require funding beyond the revenue brought in by patient care.  The original purchase of the University of Minnesota Hospital by Fairview in 1996 was driven by the idea (since proven wrong) that by combining the reputation of the University of Minnesota with Fairview’s additional beds a miraculous symbiosis would occur — allowing Minnesota taxpayers to avoid the necessary support of our University Hospital. 

The doctors and staff at the hospital will tell you there was a decline in productive research and consequently the hospitals reputation when Fairview acquired control. Prior to 1996, the University of Minnesota Medical School ranked in the top 20 U.S. medical schools for research.  Currently the University of Minnesota Medical School’s research ranking is 43rd.  Ouch.

Take a look at the University of South Dakota Sanford Medical school.  For both research and training primary care physicians they are unranked. That is below at least 124 other U.S. medical schools (There are 192 medical schools in the United States. The rankings do not go below 124.)   The University of Minnesota is ranked third in the nation for its Family Physician training program.  How do you think it will fare under Sanford?

You might be asking why this takeover is even being considered. Sanford is driven, as are almost all large corporations, by a desire for growth.  This is true in spite of the “non-profit” status of Sanford.  If Sanford gets bigger, the CEO and other Sanford executives can expect even higher compensation. 

What about Fairview?  Fairviews original bet on owning a university hospital has not turned out to be a financial windfall. I believe Fairview is looking for a way to close shop and get some golden parachutes for their executives.

Believe it or not, there are additional reasons to oppose this takeover. All the serious studies of this type of big merger show it drives up prices by reducing competition. U.S. healthcare prices are already the highest in the world by a factor of 1.5 to 2.0 (considering only modern, prosperous countries). 

The leaders of Sanford and Fairview say care will improve and cost will go down.   This is pure speculation with no evidence to support it. All evidence is cost will go up and care will not improve. Indeed, when is the last time you got great personal service from a huge corporate entity? This is not a case where larger is better.

What should we as Minnesotans do? Oppose this takeover. The Minnesota Attorney General will be holding meetings about this around the state.   Go to one of those meetings if you can (https://www.ag.state.mn.us/sanford-fairview/). Contact your Minnesota state senator and representative. Contact the governor’s office. Make a fuss. 

Wishing you all the best in 2023. May your need for healthcare be minimal and all your encounters with healthcare be good for you.

Mark Brakke is retired after caring for patients in Coon Rapids, Minn. for 41 years. He has served on boards of two HMOs. Questions relating to health care can be sent to [email protected].