Several local professionals, including Cape Girardeau's two hospital administrators, addressed Leadership Missouri participants about health care on Friday.

The 40-member group made up of community leaders from throughout the state gathered at Drury Lodge for a two-day conference titled "Missouri's Vital Signs." The program was designed to inform participants about health care, from the Air Evac service to tick-borne disease.

Chamber of Commerce President John Mehner is the only local participant in Leadership Missouri, a program designed to help business and civic leaders better understand the operations of Missouri government and the concerns and goals of state officials.

Sessions are conducted two days each month for seven months beginning in April and ending in October, with each session in a different city.

"It's a tremendous time commitment, but it takes you to all areas across the state, and you can make good contacts," Mehner said.

Program director Neil Coffin said there wasn't any particular reason behind choosing Cape Girardeau for the health care session, but the city's two hospitals made it a good topic to be discussed here.

St. Francis Medical Center Administrator John Fidler and Southeast Missouri Hospital Administrator Jim Wente addressed the leaders Friday morning. Their topic was "Contemporary Changes on Hospital Hill," but they took time to discuss their hospitals' relationship.

A question presented by the group was why St. Francis and Southeast don't merge. Wente and Fidler answered that the danger of an antitrust suit prevented a merger. Together, the hospitals control about 95 percent of the medical care market in the area, and an antitrust suit can be filed for anything more than 35 percent, they said.

Wente used his part of the program to discuss managed care, health maintenance organizations and Medicaid, three things with big impacts on hospital finances these days.

The federal government is talking about cutting back Medicare and Medicaid payments, a move that would cost hospitals millions each year, Wente said.

Instead of cutting back the programs, the government should work to educate the people on them.

"I don't believe in stereotyping the Medicaid population, but some have behavioral problems," Wente said. "If you don't think they do, sit in your hospital emergency room from 8:30 to midnight some Saturday night."

Wente also encouraged collaborative practice, which allows advanced practice nurses to write prescriptions.

"At a time when there are portions of the population not receiving health care and there is a shortage of primary-care physicians, it makes sense that advanced practice nurses working with M.D.s should be able to provide services," he said.

Fidler used his time to discuss wellness, a buzzword sweeping the medical community.

He said most people are in a neutral zone between premature death and a high level of health. With awareness and education, they could reach that level and health care costs would drop.

To educate people, Fidler said, hospitals must turn businesses and schools into health centers and take the wellness message door-to-door in low-income neighborhoods.

Southeast and St. Francis have worked together on several wellness programs, the administrators said, and will continue to do so.