TALKS AIM TO KEEP OUR HEALTH CARE LOCAL

Talks that could result in an affiliation between the two hospitals in Cape Girardeau, Southeast Missouri Hospital and St. Francis Medical Center, are going smoothly. Administrators from both hospitals said recently the talks have put the toughest issues up front. This not only is logical, it also moves the discussion at a pace that's equal to the weight of the topics under consideration. As a result, the hospitals and their respective boards believe there are many reasons for cooperation, and there is growing consensus on where these talks are headed.

Among the issues being discussed are such things as governance, staffing, cost efficiencies and protecting the ethical standards of a Catholic hospital in a secular medical setting.

Although there are many details to be worked out in each of these areas, the talks are finding more reasons to agree than to disagree. The members of the joint study commission appointed by both hospitals clearly understand that a workable plan hinges on a good management plan, addressing staffing concerns, saving money and dealing with the expectations not only of Roman Catholic principles, but the community as well.

The real test of whatever plan the study committee develops, however, will be whether or not the federal government can be convinced that a joint effort by the two hospitals will better serve this area than two separate and competing facilities.

To that end, the hospitals have asked Arthur Andersen & Co., a well-respected national consulting firm, to prepare a cost-efficiency analysis that will be used if -- and likely when -- the federal government challenges that plan.

The reality that has prompted the boards of both hospitals to pursue this course of action is simple: Without the strength of a joint operation, Cape Girardeau's two hospitals face being taken over by larger megahospital organizations that would likely have strong ties to St. Louis or Memphis. If it came to that, the two local hospitals would be competing head to head, with decisions being made elsewhere about the quality of care and the costs to those who seek health care here.

There may be some sentiment that such stiff and brutal competition would benefit hospital patients in Cape Girardeau. But the world of health care is far more complicated than retailing a manufactured product in competing stores across the street from each other. This is thanks to what has happened to insurance companies, health-maintenance organizations, Medicare, Medicaid and a whole raft of government regulations in recent years.

The joint study committee's members are part of our community and have our best interests in mind. They are looking for answers that will make hospital care here better in many respects. Along the way, they will come across issues that are difficult and complex. In the end, however, their efforts are likely to raise Cape Girardeau's position as a regional medical center by several notches.