Ask Mr. Answer Person: "How about some questions for Gundersen Lutheran now?"

Craig e-mails Mr. Answer Person: "Thank you for all your efforts concerning WMC, Mayo and Gundersen.  I feel some progress has been made but unfortunately there is still a long ways to go.  Up to this point the tough questions have seemingly all been directed at WMC and Mayo.  How about some directed to Gundersen?

At the Mayo/WMC performance at Hotel Winneshiek, the Gundersen representative said after the presentation something to the effect - That is pretty ugly if that was the full story - and he couldn't begin to respond in the 5 minutes allotted to him.  I hoped for information from Gundersen on (as Paul Harvey would say) the rest of the story.  To date the only thing has been a two paragraph ad that basically says "trust us".  Is that all we're going to get?  Is their silence vindication for the WMC position?

WMC said they had offered to make arrangements that Gundersen employees, who obviously would have Gundersen insurance as a part of their employment package, be considered "in network" at the WMC, which Gundersen declined.  Why did they decline it?  Are they willing to use their own employees as pawns in this power struggle?  If so, how does that play in their statement they want to do what's best for their patients?

Gundersen is embarking on a huge construction project at their facility in La Crosse.  Where do their demographics studies show the patients will come from to fill that complex?  How much do they need to increase their patient count from Winneshiek county to cost justify that new facility?

I'm still looking for the guys wearing the white hats and the black hats in this issue.  Most likely they're all gray, but the more information we can obtain the easier it will be to see what shade of gray each is wearing."

Mr. Answer Person says: "You've asked a lot of good questions.  Let me try to tackle them to the best of my ability—noting cases where there isn't enough information for a complete answer
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Following the Mayo Clinic Health Systems presentation at the Hotel Winneshiek, Gundersen Clinic officials issued a statement that we reported on August 8th.  You can read the story at: http://www.decorahnews.com/archived-stories/2012/08/3287.html.  Basically Gundersen officials decided not to respond to the statements made at the Hotel Winneshiek.  Their statement said "It's time for us to move on."  You can read this either as a vindication of the WMC position or as a decision by Gundersen that it was tired of the bickering in Decorah.

As for whether Gundersen—Decorah Clinic employees can be considered "in network" at Winneshiek Medical Center, neither Winneshiek Medical Center nor Gundersen wants to give in on this issue.  If Gundersen—Decorah Clinic employees go to Winneshiek Medical Center, that probably means a loss of business at Gundersen Lutheran Hospital in La Crosse.  Gundersen representatives are willing to allow this—as long as Winneshiek Medical Center starts accepting Gundersen Lutheran Health Plan patients as "in network."  The Winneshiek Medical Center Board is unwilling to do this, but says it would be HAPPY to accept new patients from Gundersen—without accepting new patients from Gundersen Lutheran Health Plan.  In other words, both sides are asking for concessions, and no agreement can be reached.

As for the construction on the Gundersen Lutheran campus in La Crosse, it's a new 400,000-square-foot hospital that's expected to open in 2013.  You can bet that Gundersen Lutheran conducted studies to make sure such a large facility would attract enough patients.  However, these studies, of course, are private studies that will not be released to the public.  It's the same "for competitive reasons" explanation that Mayo Clinic Health Systems officials use when they don't want to discuss things happening at the Decorah hospital.

So there you have it—although I'm not sure what you have!  Both organizations are working hard to maximize the number of their own patients and to compete with one another as hard as they can.  As you say, that means the two sides are perhaps more alike than they would like to admit.

One last comment, however: Mayo Clinic and Gundersen Clinic have competed strongly with one another for years and years.  What is new about health care in Winneshiek County is that the Winneshiek Medical Center Board of Trustees started aligning itself with Mayo in 2005 whereas before it tried to be a neutral party in the competition between the two giant health providers.  Most of the discussion that has taken place this year about Winneshiek Medical Center is a political and philosophical discussion about whether the hospital board has made the correct move.  So it's not so much a "Mayo versus Gundersen" discussion as it is a discussion of whether the hospital board should be neutral or should be tied tightly to one of the two health care organizations.