SURGICENTERS SOUGHT AMID MERGER TALKS

Into Cape Girardeau's vital and, by most measures, largest industry -- health care -- has recently been thrust the issue of not one but two proposed new free-standing ambulatory surgery centers. These ASCs are privately owned centers for various surgical procedures that don't require overnight hospitalization. Nationwide, ASCs have spread since the 1970s as part of a move to contain health-care costs. Doctors Park Surgery Center in Cape was one of Missouri's first to open its doors more than 20 years ago.

Cape Girardeau currently has at least nine operating rooms in the three free-standing ASCs already in business here. With two more coming on line and six more proposed, if everything wins state approval, the Cape Girardeau market would have 17 ASC operating rooms. This doesn't count the facilities for ambulatory surgery at each of the two hospitals.

The Missouri Department of Health's Facilities Review Committee must pass on the applications. At its May 31 meeting, this committee granted a waiver to Silver Springs Surgery Center for two new surgicenter operating rooms. (These two aren't included in the nine already here.) The waiver was granted on the grounds that expenditures for the new center will be below the minimum $1 million required for the state committee's review. Plans are for this center to handle plastic surgery and "possibly dental-type procedures," according to a spokesman.

The second proposal is much larger: A proposed $5.4 million facility featuring six new operating rooms. Mississippi Valley Surgery Center's application is headed by Dr. William Kapp, who would be joined as an owner by his physician colleagues at Orthopaedics Associates of Southeast Missouri. Additional surgeons who are said to be committed to working in this facility take the figure of interested physicians up to about 20. Mississippi Valley has a letter of intent on file with the committee that states its intention to file an application, probably next month, for the certificate of need required to allow its construction. The earliest the committee might take up Mississippi Valley's application would be at its Sept. 14 meeting.

At that meeting, there will be ample opportunity for public testimony, pro and con, in an open forum at which an elaborate public record is established. Lobbying of committee members by both supporters and opponents will likely be vigorous. Legal counsel will be hired by both sides. Recent deliberations of the Facilities Review Committee have seen some ASC applications approved and others cast aside or denied outright.

All this unfolds as the respective leadership groups of Cape Girardeau's two hospitals are working their way through a difficult set of issues toward what they -- casting aside previous niceties -- are openly calling an attempted merger. It is noteworthy that at this sensitive stage in these talks, neither hospital board has taken an official position. This could change over the next two months. Regardless of the merits, there is the issue of the timing of a project as large as the Mississippi Valley application and its possible effect on the merger talks.

The effort to contain health-care costs is of great moment, not just for those employed in health care, but for every citizen throughout the region. Issues of competitiveness are implicated that will decide whether Cape Girardeau can continue to be a good place to locate or expand a business. However this unfolds, we hope that facts, and not emotions or egos or parochial concerns, govern the outcome. It is important for us all that we get this one right.