As I see it - Executive Director's Column
by John Karebian, Executive Director
Many of us are watching with keen interest and concern regarding the proposed transaction between Marquette Health System and Duke LifePoint, Inc. Nurses are concerned about significant changes in the health care delivery system such as this proposed sale of a not-for-profit community hospital with a for-profit corporation. We want to ensure that services to patients are maintained or improved and that the healthcare delivery environment is enhanced, if the transaction occurs.
Non-profit hospitals have traditionally been the backbone of the American hospital system. Yet, over the past decade, powerful market forces reshaping the health care system have stimulated the rapid growth of large for-profit hospital chains such as Duke LifePoint. The public’s stake in this conversion is substantial. If the profit motive now becomes the driving force behind the delivery of health care in the Marquette region, then it is more than reasonable for consumers to fully understand what it means to their health and pocketbooks. Will the sale affect the quality of health care, and will the hospital continue to provide less profitable but essential health care services? What happens to services such as high risk obstetrics, neonatal intensive care, burn care, hospice, HIV and multiple trauma care which are essential to a community healthcare system but are inherently unprofitable? Is the battle over tax exemption versus paying taxes overshadowing the real community benefits offered by a community-based not-for-profit hospital like Marquette Health System? What is the impact on charitable care in a community with such a high rate of uninsured patients?
Drs. Steffie Woolhandler and David Himmelstein of Harvard Medical School, in a recent study, noted that "for-profits skimp on nurses but spend lavishly on their executives and paper pushers". Dr. Woolhandler went on to note that "studies have shown a consistent pattern – investor-ownership compromises care and raises costs." Marquette Health System has always had to meet its costs out of its healthcare revenues. But now, investor profits also need to be squeezed out of those revenues. What impact will the need to satisfy investors have on the quality, affordability and accessibility of care in the Marquette community? Dr. Woolhandler went on to say that costs increased by 19% for private investor-owned institutions.
In Marquette, there continues to be close public scrutiny due to a lack of transparency regarding the terms of the sale. Why does the hospital continue to identify this transaction as a "partnership opportunity" when it appears Marquette Health System will sell its assets and presumably cease operations? For Marquette Health System administrators who claim the deal will be good for everyone, hoping they are right isn’t enough. Nurses will stand with the community to exercise due diligence to ensure that any potential new owners will continue to provide accessible, affordable and quality care to the Marquette region.