HOSPITAL LEADERS STRESS REGIONAL EFFORTS

The future of health care rests with a more coordinated approach involving regional cooperation among medical facilities, the heads of Cape Girardeau's two hospitals say.

Jim Wente, administrator of Southeast Missouri Hospital, and John Fidler, president of St. Francis Medical Center, shared their visions of health care in a joint interview with the Southeast Missourian.

The boards of directors of the two hospitals announced last week that they plan to pursue collaborative efforts to improve the area's health care services.

Wente said centralized purchasing is one possible collaborative venture that could streamline costs.

The two hospitals might also consider the possibility of some type of shared, air-ambulance service, Wente and Fidler said.

Currently, there are two air ambulance services, one at each hospital. "I think it's worked well and very cost-effectively," Fidler maintained.

But he said it makes sense for the two hospitals "to pool our talents" in dealing with the "next generation" of air-ambulance service. He said that could involve perhaps two larger helicopters or three helicopters serving a much bigger region.

Wente said, "Air ambulances is just one item that can be explored as to how we can do that better. That doesn't say we're doing it bad now. Both of those helicopters are flying."

Wente said the public may not realize that Southeast's LifeBeat helicopter and St. Francis' Air Evac currently make trips to both hospitals and there's communication between the two services.

In addition, he said, collaborative efforts could extend to other hospitals in the region. But neither he nor Fidler would predict when any collaborative venture might be put in operation, either locally or on a more regional basis.

"The involvement of the other hospitals within our service area is critical and we have had dialogue with other hospital administrators as to how we can meet each other's needs," said Wente.

"I think there will still be competition in health care, but it's going to be more system-oriented competition where systems of hospitals and networks of hospitals will be competing against each other in terms of quality from market sharing and so forth as opposed to individual hospitals," he said.

The two Cape Girardeau hospital administrators said they would like to see a cooperative effort involving hospitals in the Southeast Missouri and Southern Illinois region.

"The primary service area of the two hospitals is about 200,000 (in population)," said Fidler. But the entire service area has a population of around 400,000, he estimated.

Wente maintained that cooperative ventures between Southeast and St. Francis would allow the hospitals to "probably compete very strongly" under a new national health care system.

Fidler said the nation's health care problem is rooted in extremes. "On the one hand, we have the best health care system in the world. If you're truly about to die, this is the place to come. We create miracles every day."

But he said "we spend too much of our resources caring for people after they fail to care for themselves."

There's also an access problem. Those who don't have health insurance or regular access to doctors' care end up using hospital emergency rooms, which is a more costly alternative, Fidler said.

"And then your other basic issue is that we have a payment structure, which rewards illness," he noted.

Insurance companies often will "pay for a baby that's sick, at the point of dying. But they don't pay for well-baby care to keep the baby well," said Fidler.

"The other thing is, we don't have a health care system," he said. Instead, the nation's health care is provided by individual doctors and hospitals, said Fidler.

He said the collaborative efforts of St. Francis and Southeast hospitals can provide an improved health care system.

"Basically, I think that's the exciting part because we're seeing, at least on a national reform level, some pressure to create area health care networks that have the capability of delivering measurable, quality care to a large population. And to do that, we're going to have to come together and create that integrated system," said Fidler.

A health care network, he said, allows for more efficient delivery of services over a large area and would improve access. Also, such a system would eliminate duplicate billing and support systems, he maintained.

Competition in the medical field only drives up costs, Wente said.

"Everything you know in economics, the opposite is true in health care," added Fidler. "It is not an economics-driven system. It is a social service-driven industry. By and large, we are responding to human need."