ON the Fairview Sanford Hospital Merger From Hell

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A lowkey riveting hearing went down in Minnesota yesterday on a $14 billion hospital merger. I'm highlighting because: -It's a central casting hospital merger from hell -Everyone personally affected clearly HATES the deal -It will probably go through anyway? -Welcome to Hellcare

the deal joins dominant Twin Cities system M Health Fairview & rural South Dakota chain Sanford Health. The chains have no real "synergies" but have been trying to merge for AGES. The 1st time they tried in 2013, the AG grilled Sanford so hard they walked away.

Since 2013 -both chains have >doubled in size -Sanford paid $20m to settle an unnecessary spine surgery case -Causing an Iowa hospital system to back out of merging w Sanford -its CEO "resigned" after refusing to wear a mask in 2020 -then got a $50 MILLION golden parachute

MEANWHILE Sanford himself, a subprime credit card billionaire known for 80% APRs, has been under investigation for the possession of CHILD PORNOGRAPHY for years. Last spring the probe was shut down after Sanford claimed his email had been hacked. ProPublica remains on the case

Fairview is a similarly loathesome system kept somewhat in check by incrementally more robust regulation/governance. Since swallowing a major competitor in 2017 it has shut down multiple hospitals & mutliple maternity wards. Fairview nurses who spoke audibly despise their bosses

One of Fairview's enduring qualities: a zest for shaking down patients. In 2005 the AG censured F for illegally garnishing patients' Social Security checks. So Fairview outsourced collections to private equity-owned Accretive Health, since renamed R1 RCM storage.courtlistener.com/recap/gov.uscourts.mnd.124205/gov.uscourts.mnd.124205.82.0.pdf

Accretive called its strategy "Accretive Secet Sauce." "You've never seen ASS like ours!" the company bragged in internal documents Agents of ASS camped out in ERs and, posing as nurses, stormed into the rooms of sick patients demanding $ as a perceived condition for getting care

Then AG Lori Swanson sued & banned from the state Accretive in 2012 & was likely in no mood to approve a buyout that wd enrich the hospital bosses who'd hired them. She chased Sanford away. For whatever reason, current @AGEllison seems reluctant to do the same.

One reservation may be related to the fact that antitrust has been historically unhelpful in combating the scourge of health care consolidation. Sanford & Fairview don't have many overlapping assets, so what could be "anticompetitive" about it? WELL... fiercehealthcare.com/providers/cross-market-hospital-consolidation-rise-and-understudied-researchers-say

A better question to ask about mergers is, if it's *not* going to have anticompetitive consequences, why the F are the big bosses pushing for it so hard? Yesterday the Fairview CEO all but said "Look folks we need to raise prices" kare11.com/video/news/health/ceos-of-fairview-sanford-discuss-potential-merger-at-public-hearing/89-74269a7d-5ea6-48d6-b120-6bfc5ef82248

(Cross-market mergers enable hospital CEOs to jack up prices for the same reason the merger of a psoriasis drugmaker & a cancer biotech does: *patients* aren't the ones haggling over prices, giant (corrupt) insurers are. Sadly antitrust has only recently started grasping this.)

Luckily @mnnurses & the @MNFarmersUnion & @SEIUmn & the dean of the @UMNMedschool & state rep @zackstephenson all seem committed to opposing the merger & other Fairview scams to undermine MN health care standards & sell out to sicko hospital monopolists.

Even if they succeed at winning Ellison over, MN clinicians & patients are stuck with Fairview's scummy leadership. And the 100 hospital merger bids like this one happening at any given time, all designed to maximize health care costs & clinician burnout revcycleintelligence.com/news/healthcare-mergers-and-acquisitions-linked-to-physician-burnout