by Sean Fitzgerald
February 10, 2002
I'm not planning to make this into a local health care column each week. I had other plans in place, but I couldn't help changing direction after receiving a call late Thursday afternoon from Rep. DuWayne Johnsrud, R-Eastman, calling Aurora Health Care, Inc. "the new Wal-Mart of health care."
He didn't go into much detail, except to say that Aurora has spent hundreds of millions of dollars building facilities across eastern Wisconsin in the past three years. He compared this trend to the Wal-Mart stores in two communities he serves, which have been abandoned to build SuperWal-Mart stores in each community.
While the parallel might be shaky at best, Johnsrud did mention the debt Aurora took on for capital projects through the Wisconsin Health and Educational Facilities Authority, an institution which assists hospitals and schools obtain low-interest financing. Aurora borrowed $105 million last year and a total of $250 million in 1999.On a separate note, Ministry Health Care, one of the sponsors for Mercy Medical Center, also borrowed $110 million in 2000 through the agency.
Johnsrud said he thinks these figures are getting out of hand.
"Outfits like Aurora think competition is good," Johnsrud said. "That's not the case in health care. It's like having two or three policing units and having them compete against each other in a community."
"There's only so many dollars going around. There's only so much need to be met," he said. "(Health care) is not something we set up to be an Enron-sort of business. Unfortunately, we're all stockholders because we pay the premiums on health care insurance."
When Johnsrud was first sworn in the legislature in 1985, his first speech on the floor of the Assembly advocated the removal of the Capital Expenditure Review. The law - which required administrators of health care facilities in Wisconsin to receive state approval for capital expenditures ranging from new hospital construction to the simple purchase of MRI equipment - eventually was dissolved as a result of Johnsrud's efforts.
"I remember the hospitals saying, 'Oh, we're never going to gouge the public, and we're not going to survive if the law continued to stay in place,'" Johnsrud said.
A decade and a half later, he admits his views have changed. "I've gone 180 degrees," Johnsrud said. "My first floor speech was to get rid of them, because the hospitals said they wouldn't raise rates. I got lied to, and everybody got lied to. We need to go back to Capital Expenditure Review."
A senior member of the Assembly Health committee chaired by Rep. Gregg Underheim, R-Oshkosh, Johnsrud said its time to bring back state regulation of health care capital expenditures. He also said it's time for the state to regulate the rates set by health care providers. Johnsrud plans to bring both issues in front of the Health committee, he said Thursday, though he doesn't have legislation drafted, yet.
Lately, Johnsrud has been politicking to pass his state trauma system bill, which would regulate the number of Level II trauma facilities in a given market. He said he caught a lot of flack from certain segments of the state hospital community which don't want the bill to succeed.
Yet, it breezed through the Assembly last Monday by a 97-0 vote. It's now on its way to the Senate.
By the way, Aurora BayCare Medical Center in Green Bay won a small battle in its plight to become a Level II trauma facility Thursday. It still needs approval from the American College of Surgeons.
SEAN FITZGERALD: 426-6678 OR SFITZGERAL@SMGPO.GANNETT.COM