Fixing the operation of Winneshiek Medical Center

If you traveled to the UNI-Dome this Thursday to see Decorah High School's football game against Williamsburg and you noticed that the referees were wearing the team colors of Williamsburg, what would be your reaction?  The referees could tell you--and they might be right--that the clothing they were wearing wouldn't affect their ability to make fair calls.  But as soon as there was a close call that went in favor of Williamsburg, you'd be wondering whether the referees were truly impartial--wouldn't you?

Which brings me to Winneshiek Medical Center.  After six months of writing news stories about the issues being faced by the hospital, it took going on a trip out of town for me to realize what is at the root of the hospital's current struggles.

I have come back from Tomah, Wisconsin understanding how important organizational structure is.  I now believe that the hospital's problems with sluggish financial figures and at least some public unhappiness is due to the fact that it now is neither fully a private hospital nor fully a public hospital.

For instance, when you drive to Winneshiek Medical Center, you see the Mayo Clinic Health Systems logo on the welcoming sign.  When you visit the Winneshiek Medical Center website, you see only Mayo doctors listed. This would lead you to believe the hospital is a Mayo hospital.

But the hospital board wants other health care providers to send more business to the hospital.  This is like having a taxpayer-supported "Winneshiek Truck Center" be run by General Motors--and wondering why Ford isn't sending over more customers.

This year we have also had Mayo Clinic Health Systems employees get up in public and give presentations about why Gundersen Clinic is an unfair competitor and why the Gundersen Lutheran Health Plan shouldn't be accepted as an in-network provider at the hospital.  This is their right and responsibility to speak out for what they feel is best for the hospital.  But if we had a Winneshiek Fast Food Center run by Mc Donald's and Mc Donald's officials publicly criticized Culver's, would we be surprised that Culver's didn't send over more business?

What is happening now at Winneshiek Medical Center is that the board and the administrators are acting like the hospital is a public hospital only when it suits them.  For instance, the agenda on this coming Wednesday's hospital board meeting calls for another discussion about the Winneshiek County taxpayers subsidy of the hospital--the second month in a row this topic will come up.  Is this the beginning of a campaign to justify a larger tax subsidy?

Members of the public who have talked to me about the hospital in the last six months have almost universally said, "I knew there was something wrong--I just couldn't put my finger on it."

This editorial today is an effort on my part to crystallize the discussion about the future of the hospital.  It seems to me that the time has come to change the current structure of operation for Winneshiek Medical Center and to pick one of two options--both of which are VERY workable:

1)  Have Winneshiek Medical Center operate as a private hospital.
Mayo Clinic is the BEST medical group in the world.  There is NOTHING wrong with having Winneshiek Medical Center become a Mayo Clinic hospital.

If the public chooses this option, however, the tax subsidy of the hospital must end.  There's no reason Winneshiek County taxpayers need to subsidize a rich and powerful corporation like Mayo.  Furthermore, it would be only fair to have Mayo buy the property the hospital sits on and reach an agreement with the hospital board about the purchase of the hospital and clinic buildings.

A privately-run hospital could make whatever decisions it wants about which insurance plans to accept.  Heck, it could even have its doctors make all the unflattering comments about other health care providers they wished to make!

2)  Have Winneshiek Medical Center become a fully public hospital.
Under this option, the hospital board would end its Management Services Agreement with Mayo Clinic Health Systems when it expires in 2015 (notification must be made by 2014).  Administrators at the hospital would be hired directly by the hospital board and an independent management consulting firm would be hired.

As I saw in Tomah, independent administrators and consultant firms have an easier time navigating between competing health groups.  Because of that, they have an easier time getting business from those competing health organizations.

I know because decorahnews.com has been posting numerous stories about Winneshiek Medical Center in the past six months, some readers feel that I favor Gundersen Clinic over Mayo Clinic.  That is not the case.  Both are huge corporations that are looking out first and foremost for their own interests and their own profits.  The question is not what's right for either one of those corporations--it's what's right for us in Winneshiek County.

And that decision needs to be made by members of the public--not by "some blogger," as some hospital officials occasionally describe me!

So as voters head to the polls Tuesday to elect two new members of the Winneshiek Medical Center Board of Trustees, my message is a simple one--it's not enough for you to just cast a ballot.  Your job is to contact hospital board members after election day to make sure you tell them which kind of organizational structure the hospital should have.

My conclusion is that either of these choices--a private hospital or a public hospital--would be a good choice, but having a hospital that acts like a public hospital some times and a private hospital other times is not working.