Open-heart surgeries must allow choice, price options

August 23, 2010
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Metro Health Hospital’s renewed bid to the Michigan Department of Community Health to provide open heart surgery offers the business community a glimpse of the labyrinth of health care cost factors, and some appreciation for the vicious circle that continues to spiral benefit costs to well more than 20 percent of the Gross Domestic Product in this country — even before President Barack Obama’s national health care plan takes effect.

First, it is the process: The MDCH does not allow hospitals to offer (increasingly) common heart catheterizations except in emergencies unless the facility also provides open heart surgery (which also requires state approval). Patients who may have need of diagnostic heart procedures at Saint Mary’s Health Care or Metro Health, for instance, must transfer to Spectrum Health, which already has MDCH open-heart approval, and the physician must then perform the procedure at Spectrum.

Metro Heart and Vascular physician John Key told the Business Journal earlier this spring that the physicians at other hospitals wait for bed availability or cath lab openings at Spectrum. “There’s not an insignificant cost … associated with having to transfer patients, having to duplicate staff and supplies at the other hospital,” he said. “We already have the patient on the table in the cath lab room with supplies open and all that … when we transfer them. Then all those supplies and stuff have to be reopened at Spectrum. It’s an all new set of staff. There’s not an insignificant cost to the patient and providers.” 

Key also noted that demand for such services has increased since the hospital’s move to Wyoming in 2007, but because of the transfers, that increased demand boosts the Spectrum numbers, used by MDCH to determine community need. Contrarily, local hospitals are allowed by state rules to perform such catheterizations in emergency situations.

MDCH is gathering a committee to review the rules under its Certificate of Need Commission. The Business Journal applauds this review, in addition to a more thorough examination of contrary regulations that boost the cost of procedures. It is no wonder that hospitals across the state are supporting Metro’s time- and labor-intensive request to MDCH. This is not to say that state oversight isn’t important; indeed it is, as it prevents unnecessary and far more costly duplication of services. The review is necessary for logical conclusion.

The review also begs the question of monopolistic practices. The local business community already has been visited with price increases for such procedures by Spectrum that are well beyond those of other local hospitals.

Because of the health department rules, Metro also has applied for a Certificate of Need to begin open heart surgeries. It is, regardless of rules, a worthwhile endeavor, offering patients choice as well as a price alternative. It is rewarding to find support of that request from the University of Michigan Health System CEO and executive vice president for medical affairs as well as support from local groups such as the Physicians Organization of West Michigan, Trinity Health and Borgess Medical Center.

Metro Health CEO Michael Faas said it best: “The Certificate of Need is really about need. It’s not about creating franchises or creating monopolies. It’s not just about volume in one location. It’s about access, it’s about cost and it’s about quality.”

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