The beauty –and bane—of Rhode Island is that you can leave the state for a generation and walk right back into the same conversation.
This everything-old-is-new again is very much the case in the never-ending joust over the plan for a giant Boston hospital chain to take over Care New England, Rhode Island’s second largest hospital system.
For decades, it’s long been a full-employment reservoir for lawyers, lobbyists and flacks. Now, in the fourth quarter of this game, executives of Lifespan, Rhode Island’s largest hospital chain, are throwing a hail-Mary pass in an attempt to keep the Boston medical giant out of Rhode Island.
Lifespan, anchored by Rhode Island and Miriam hospitals, the two big Providence-based academic medical centers, fears a link between Boston and Care New England, anchored by Kent Hospital in Warwick and Women & Infants. As the days dwindle until state regulators consider the Partners-Brigham Health of Boston acquisition of Care New England, Lifespan CEO Tim Babineau has launched a campaign to scuttle the deal.
Babineau and other Lifespan bigwigs have established a web site and embarked on a media flurry to warn that Rhode Island health care consumers face “dire consequences” if the deal goes through. He cited quality of care, costs and the need for a unified Rhode Island hospital system.
Let’s get beyond the faux pieties of the hospital industry. All this chatter about quality, access and a unified health system in Rhode Island is a facade for the real issues: Money and turf.
Lifespan’s position isn’t wrong, says Anya Rader Wallack, a professor at the Brown University School of Public Health. “There are efficiencies that could be achieved with a Care New England—Lifespan combination. But the current leadership hasn’t found a way to make that happen.”
It isn’t like they haven’t had a chance –this issue has been batted around for more than two decades. There have been negotiations that lasted longer than the Paris Peace Talks. Most of this has taken place behind closed doors, so it’s difficult to sort out the serious issues from the rhetoric and turf jealousies. Another case of the smallest state with the biggest egos, perhaps?
Lifespan says the merger will mean Rhode Island health care decisions will be “relinquished to executives who know little about Rhode Islanders and the critical role of health care in our state.”
Care New England’s counter is that their hospitals would get much needed money and resources from the Boston group that would stabilize the chain’s finances and develop more community-care centers that could lead to lower costs.
Approval of the merger would probably mean that Lifespan would lose patients to Boston, says health consultant Ken Kaufman. “It’s not like you’re in Texas. There’s only a certain number of patients in Rhode Island.”
If some of those patients go to Boston, that means fewer for Lifespan. Experts say Lifespan worries that patients with good insurance will take their expensive procedures –think hip and knee replacements—to Boston. That would leave Lifespan hospitals with lower-profit patients, such as those on Medicaid and Medicare.
Were this a real private sector market, somebody’s head at Lifespan would roll. Babineau may be right. But the $2 million a year CEO has been at the helm of Lifespan since 2012 and hasn’t been able to get a Rhode Island merger done.
Lifespan executives aren’t the only people in the Ocean State health care community who have failed. The state’s political leaders have been AWOL, content to allow the feuding hospital chains to get to the point where Boston’s hospitals saw an opening and avidly pursued it.
The General Assembly has done a poor job of setting health care priorities. What has happened over the years is the usual Rhode Island game of lawmakers’ protecting the hospitals in their districts and not worrying much about the overall health of the state’s hospital networks.
Gov. Gina Raimondo has paid little more than lip service to the hospital merger. Maybe Raimondo should have hired a team of top-flight consultants and started a study of hospital needs before she vacuumed up campaign contributions at a $1,000 per person Boston fund-raiser last June hosted by the chairman emeritus of the board of the Boston hospitals.
The sad aspect of all this is that the taxpayers finance more than 60 percent of hospital costs through government health programs. As the ego and money battles continue, It doesn’t appear anyone is representing their interests.
Scott MacKay’s commentary can be heard every Monday on Morning Edition at 6:45 and 8:45 and at 5:44 in the afternoon.
