LETTERS: HOSPITAL MERGER PLAN IS FLAWED

To the editor:

The merger of St. Francis Medical Center and Southeast Missouri Hospital is a matter of great importance to the area. Following is a copy of our letter to Missouri Attorney General Jay Nixon, which we ask that you print in its entirety. Thank you for your courtesy.

Dear Mr. Nixon:

The proposed merger between St. Francis Medical Center and Southeast Missouri Hospital is a bad plan for the future of hospital services for Southeast Missouri and Southern Illinois.

Competition is essential for a sound market, and hospital service is no exception. Because of the vigorous competition between St. Francis and Southeast Missouri Hospital, area residents benefit from the finest health-care services ever available in this region. To name just two examples, Southeast Missouri Hospital has made great strides in oncology and related treatment. The heart surgeons at St. Francis now report success rates rivaling the premier heart institutions in the country.

Significantly, both hospitals are providing these services while maintaining solid financial positions.

Reports say the merger will "save" the hospitals $44 million. These savings are questionable. A substantial portion of the savings would come from not constructing another large medical office building. But this is creative accounting, not savings. The issue of whether our community is better served by another medical building must be addressed without regard to a merger. Another medical building is not needed in Cape Girardeau and should not be built, period. An efficiency analysis founded upon savings from eliminating unnecessary projects lacks credibility.

The hospitals claim the merger is necessary for "local control." However, the interest of local control does not justify a monopoly. Moreover, as the only hospital serving Southeast Missouri and Southern Illinois after the merger, the hospital will be a prime target for the national hospital corporations. Yet, nothing in the merger plan prevent a sale to out-of-town interests.

As you are aware, in Poplar Bluff, as here in Cape Girardeau, the only two hospitals of any size serving the community (Lucy Lee and Doctors' Regional Medical Center), attempted a merger. In Poplar Bluff, the Department of Justice and the state of Missouri opposed the merger and sought a preliminary injunction in the U.S. District Court. Federal Judge Catherine Perry granted the injunction, firmly rejecting the merger. In doing so, Judge Perry said:

"The merger is likely to have anti-competitive effects because the intense competition between (the hospitals), which has resulted in significant benefits for the consumer and encouraged efficiency, will be eliminated. ... The competition has promoted improved hospital quality and service. ... To compete within the market, (the hospitals) have routinely added new services, recruited high-quality physicians to an area that traditionally would have difficulties attracting physicians, and established rural outreach clinics."

Substitute Cape Girardeau for Poplar Bluff, and St. Francis and Southeast Missouri for Lucy Lee and Doctors' Regional. The parallels are striking, but not surprising. This is because, as Judge Perry correctly identified, the "crux" of the issue is whether there are practical alternatives after the merger.

Consider the lack of practical alternatives for persons affected by a merger in Cape Girardeau. What are the alternatives as an employers when the hospital raises prices? Do you tell your employees they must now go to St. Louis because the Cape Girardeau hospital is no longer competitive? Consider the alternatives as a patient. Do you favor Memphis or Poplar Bluff? As a hospital employee, what is the alternative when the hospital says "take it or leave it" when discussing wages? What is a local physician's alternative when the hospital dictates the number of nurses needed for a particular procedure?

The answers are self-evident: After the merger, there will be no real alternative for hospital services in Southeast Missouri and Southern Illinois.

The merger plan offers little to assure adequate competition or savings for the community. The plan supposedly guarantees certain levels of hospital savings. But the fine print says the levels can be adjusted if business is bad, or for prices the hospital could have charged but didn't. This hardly resembles a guarantee.

For the hospital patient, the price charged by the hospital, not the hospital's cost of doing business, is the real measure. On that score, the merger plan is sorely lacking. Price increases are projected to be no greater than the overall health-care industry increases, but only for the first five years, and only if business is good. To be blunt, so what? Where are the price savings?

Like the major area employers, doctors and many other Southeast Missouri residents, we have no choice but to oppose this merger. Despite the carefully orchestrated news releases and pie-in-the-sky promises of savings, the hospitals have offered no tangible, compelling reasons to impose a hospital monopoly upon the residents of Southeast Missouri and Southern Illinois. We look forward to discussing these issues with you at the hearing in Cape Girardeau and thank you for your consideration.

ROBERT A. DRURY, ANNA R. DRURY, HERBERT J. WEDEMEIER, LORETTA A. SCHNEIDER, VERNICE V. BAUMSTARK, LARRY WESTRICH, DENNIS VOLLINK, KENNY HORRELL, CHARLOTTE JAUCH, MSGR. JOSEPH E. GOSCHE, ERVIN H. VOGELSANG, LYNN H. VOGELSANG, OLINDA R. AUG, JAMES M. WALLACE, MARK SCULLY, EDNA JANSEN, BARB HAMMERS, CLETUS L. JANSEN, MARY FOX, ONA P. GERINGER, JOE MIRGEAUX, ERNIE BEUSSINK, IRENE BEUSSINK, PAYTON O. PATRICK, DONNA BEUSSINK, DEAN HEURING, RICK KLIPFEL, CHRIS LAYTON, STEVE BROWN, GREG JANSEN, KATHY JANSEN, JOHN JANSEN, DONNY BOND, MARTIN L. JANSEN, MARY J. JANSEN, KRISTA KEESEE, J.W. ARMBRUSTER, J. TLAPEK, KENNETH BEUSSINK, CHARLENE URHAHN, ROBERT T. YOUNG, BONNIE S. COCHRAN, MICHAEL T. YOUNG, DAVID PATRICK, RUTH MORRISON, LYNN GEISER, DENITA HARTLE, CAROLYN YOUNG and CORRIE J. YOUNG

Cape Girardeau