COLUMBIA, Mo. — Boone Hospital Center President Jim Sinek says he can’t make heads or tails of a proposed deal between the University of Missouri and healthcare giant Nueterra to build a new healthcare facility in the heart of Columbia.
“I haven’t heard any logic or rationale to this application,” Sinek said.
The University of Missouri has entered into a partnership with Nueterra, a behemoth healthcare industry staple, to seek approval to build a 10-bed hospital in Columbia for upwards of $40 million. Like any hospital in the state, the project needs approval of a Certificate of Need (CON) board before beginning construction. Missouri has had such CON procedures since the 1980’s, an effort to reduce an over-saturation of healthcare services, which have significant cost to the taxpayer.
The new facility — which UM hopes will be approved at the July 13 CON meeting and which Boone County Hopsital Center officials say is “absurd” — states in its application that it is intended to serve primarily the Fulton area, where there are far fewer hospital beds than Columbia’s staggering 1,100-plus.
For Sinek and Boone and it’s almost 400 beds, the addition of a specialized hospital looking to poach certain surgical services and well-insured patients, the new facility is an example of a fundamental misunderstanding of the healthcare industry.
“A lot of people, including legislators, will look at healthcare as the same kind of business as hotels, restaurants, gas stations, in that the more competition the better,” Sinek told The Missouri Times. “We don’t serve not normal consumers. We don’t shop or have the freedom to go to whatever hospital or doctor we want much of the time. It’s not like a person gets up one day and just decides they want to have a knee surgery.”
Hospitals cost the taxpayer a lot of money, which is something most folks understand on some level, Sinek said. But what most people don’t realize is that hospitals like Boone tend to make up the loss they take serving uninsured patients or Medicaid recipients either by state and federal reimbursements funded by taxpayers, or by subsidizing the cost through commercial payers like the insurance companies through which businesses provide employees their healthcare.
“If you have a medical arms race, every hospital trying to do a heart surgery and every one has the latest and greatest technology only to use it twice a year, those taxpayers bear that cost,” Sinek said. “We bear the cost of the that through the pricing mechanism and the contractual mechanism that these other commerical payers have with hospitals.”
The new UM-proposed facility is only for 10 beds, but the cost and size of the project, along with some parallel moves related to local zoning, hint that the facility is likely going to begin at 10 beds and immediately look to expand. Once approved for 10 beds by the CON, the facility is legally free to expand at will, with no additional scrutiny from the CON.
And while the application for the new facility indicates a desire to serve the Fulton area and not Columbia, the proposed location is, vexingly, on the farthest western-edge of its own proposed service area, rather than somewhere near the middle. (See image)
Boone, a non-profit, returns more than $2 million annually to the local community, while Nueterra, a for-profit company, has an obligation to shareholders to turn a profit, leaving folks like Sinek convened that the facility’s real goal is to poach well-insured patients and specialty procedures from the Columbia area, something that would likely make Boone even more reliant on state taxpayers.
The next meeting of the CON board is July 13.
Collin Reischman was the Managing Editor for The Missouri Times, and a graduate of Webster University with a Bachelor of Arts in Journalism.
