HOSPITALS SPLIT ON MERITS OF MERGING

Cape Girardeau's two hospitals are divided over the merits of merging.

Southeast Missouri Hospital officials favor such a move, while those at St. Francis Medical Center oppose it.

"We would do it tomorrow," said Charles Hutson, president of Southeast Hospital's Board of Trustees.

Southeast Hospital officials aren't the only ones favoring a merger. Mary Dunn, executive director of the Southeast Missouri Business Group on Health, said Wednesday that her organization believes the hospitals should merge.

"There is no way we are going to have quality health care at affordable cost if these hospitals don't merge their assets," said Dunn, whose organization encompasses 90 businesses, with about 31,000 employees and dependents.

Supporters say a merger would allow for more efficient hospital care in the area by eliminating costly duplication of both equipment and programs. There isn't a need, for example, for both hospitals to have heart programs, they contend.

But critics like John Fidler, president of St. Francis Medical Center, say a complete merger could result in layoffs.

Fidler would prefer to see what he calls "collaborative competition" in which the two hospitals would compete but also work together on some programs and projects.

Competition, he said, benefits the health care consumer.

"If you do a study of mergers, most of them have not delivered the proclaimed benefits and in many cases it has been the opposite," said Fidler.

But Hutson said that in today's climate of health-care reform, more hospitals are merging nationwide.

With managed or discounted care becoming an increasing part of the health-care picture nationally, a merger of Cape's two hospitals makes sense, said Hutson.

"With discount medicine coming in, the hospitals are going to have to tighten their belts," said Hutson. "If we don't learn how to become financially efficient and cut this tremendous duplication of services, we both very well could be in some hot water."

He said a committee of representatives of both hospitals has explored the possibility of a merger, but the talks died early last year because of a lack of interest on the part of St. Francis officials.

Hutson said Southeast Hospital officials envision that even with a merger, both hospitals would continue to operate and maintain their separate identities.

A "super board," which would include representatives from both hospitals, would oversee matters, such as the purchase of high-tech equipment.

Nationwide, there are more hospital beds than needed. Hutson said Cape's two not-for-profit hospitals generally use only 50 to 60 percent of their beds at a time.

St. Francis, which has 248 beds, has about 148 filled on a given day. On average, Southeast has 132 of its 247 beds filled daily.

In the past 10 years, the cost pressures of managed care, coupled with too many hospital beds, have forced about 500 hospitals to close nationwide.

More medical procedures are being done in outpatient centers and patients are spending less time in the hospital. On average nationwide, a hospital's total expense rose 150 percent from 1982 to 1992, sparked in part by the fast pace of advances in medical technology.

Dr. Mark Kasten, a Cape Girardeau physician who also serves as chief of staff at Southeast Hospital, believes the majority of doctors locally favor some type of partnership between the two hospitals.

Kasten, who participated in the merger talks, said both hospitals need to work together, even if it isn't a complete merger. "I think in this time of health-care reform and cost cutting, that it is essential that it happen."

Both hospitals have joined forces in a number of efforts, including the recent establishment of a purchasing group involving a number of regional hospitals. The goal is to purchase supplies at a reduced cost.

Five area hospitals, including St. Francis and Southeast, recently formed the region's first physician hospital organization (PHO).

The group hopes to bring coordinated medical services and more competitive pricing to the region.

But Dunn and others said such an organization doesn't replace the need for a merger of the two hospitals and development of "an organized system" of health care.