Holding patients captive

8/3/2001

Paramount Health Care's decision to stop covering costs for patients they insure who prefer to go to St. Charles or Riverside hospitals eventually reduces choice in medical care for more than 200,000 people.

It appears the final step in ProMedica's effort to draw competitive lines in medical care in this region in a process that would force patients' hands. St. Charles and Riverside are affiliate hospitals of Mercy Health Partners, ProMedica's competitor.

ProMedica, of which Paramount is a subsidiary, has been a busy player in reshaping the local health-care market for some time now, launching duplicative services, such as a helicopter rescue unit; and initiating an edifice complex to which rival St. Vincent/ Mercy Medical Center has had to react to the cost detriment of medical care in this region and of patients. And in the process it has moved care centers outside Toledo city limits, sapping the urban core of amenities.

It's clear that ProMedica is clearing the way for patients east of the Maumee to make ProMedica's new Bay Park Community Hospital in Oregon their facility of choice.

St. Vincent/Mercy has played much the same game. Its insurance plan won't cover care at ProMedica facilities. It joined with Medical College of Ohio to form a children's hospital, though one had already long been started at Toledo Hospital, a ProMedica facility. The two are said to specialize in different ailments, but the region doesn't need the dual overheads. Ideally a children's hospital would welcome the collaboration of St. V's, MCO, and ProMedica.

It is equally deleterious, and insulting to those who fought hard for so many years for a medical school in Toledo, that ProMedica severed its relationship with Medical College of Ohio a few years back and has not renewed it.

The school patched together a pact with St. V's, but it limits the range of exposure its students can get in areas such as gynecology - given the hospital's faith-based orientation - and in orthopedics - where MCO students and doctors compete with osteopathic students for training and patients. The risk is that this tinkering could make MCO ripe for legislative cuts.

ProMedica is right when it points out that alignment of health-care providers and insurers under one umbrella is a national trend. But when health-care decisions are made tougher by reduced choices, it's difficult to see how that is a plus.

It's not helpful when health executives indulge in muscle-flexing, or, as we have noted before, when union bosses ask their members to boycott Paramount because of the union's failure to organize lower-level Toledo Hospital employees.

Medicine is about science. It is about caring. It is about proficiency and straightforwardness. There are fine doctors affiliated with both St. Vincent/Mercy and ProMedica facilities, some better than others. Why deny people in this area access to the best at both?

What northwest Ohio needs is leadership from the hospitals, from the major employers, from unions, and from vociferous consumers, that recognizes the advantages of joint accomplishment. Hanging together beats hanging separately.