Opperman’s Take on the Governor’s Health Task Force
[Editor’s note: This letter appears in our upcoming February/March issue. The academic health task force released its final report and recommendations on Monday, Feb. 5 after that issue had gone to press. The group called for strategic investments to support the “the broader health system and workforce needs of the future,” including research and education, plus a new hospital building.]
To: Chair Jan Malcolm
Task force on Academic Health at the University of Minnesota
Minnesota Department of Health
Dear Chair Malcolm:
Gov. Tim Walz, on Aug. 10, 2023, established a Task Force on Academic Health. He appointed you, a former state health commissioner, as chair. Great choice, because you are pleasantly persistent. The persistent quality has been much needed, as the task force drove to meet its deadline of Jan. 24. The task force itself consisted of a remarkable number of Minnesotans with deep experience, and in particular, as two non-voting members, former governors Tim Pawlenty and Mark Dayton.
The task force met nine times for three hours each, and all meetings were open to the public. The materials submitted to the task force are available online at health.state.mn.us (under Facilities). Why was a task force of this caliber needed?
Fairview Health Services purchased the University of Minnesota hospitals in 1997. Continuing to run the system became an intolerable financial drain on Fairview. Both the university and Fairview want a new agreement. At the same time, Sanford Health, headquartered in South Dakota, negotiated a sale agreement with Fairview. Ultimately, under legislative and attorney general pressure, this potential merger fell apart.
It became clear from a variety of presentations and viewpoints that a new arrangement and expansion of the university Academic Health Center (comprising the U’s hospitals, clinics, and schools) would best serve the citizens of the state of Minnesota.
As this letter is being sent to you, the final language of the task force report is being drafted, and a new agreement between Fairview and the University of Minnesota has not been publicly announced. Nevertheless, the direction is clear.
A central task force recommendation is a legislative request for an additional $80 million annually to cover specifically enumerated programs. A second recommendation is for the Academic Health System to expand both geographically and demographically. Gov. Pawlenty was a persistent voice, urging the task force to make University of Minnesota health services of high quality available to all citizens of Minnesota. Finally, throughout the recommendations is the implicit assumption that following successful negotiations with Fairview, the University of Minnesota will reacquire ownership of its hospitals.
The task force recommendations represent a carefully designed road map for improving the delivery of medical care by the University of Minnesota. The final report is a great first step, but more steps are needed.
Hospital. Apart from upgrading the existing hospitals at the University of Minnesota, after ownership transfers back to the university, a new 21st century hospital (and infrastructure) will be required. The hesitancy of the task force to spell out the dollar amount of such an undertaking reflects the concern that other available medical facilities would be overlooked, and that “sticker shock” would prompt a negative public and legislative reaction. Most of the experts who have analyzed the need for a new hospital have said that the total cost would be in the $1 billion to $2 billion range (including all infrastructure). The editorial board of the Minneapolis newspaper noted that the bar had been set very high for new “competitive” hospitals by the University of Iowa when it announced a more than
$1 billion project. The Mayo Clinic has announced a $5 billion expansion of its facilities in Rochester—fulfilling its promise when the state established the Destination Medical Center in 2013. The new hospital issue should be resolved quickly.
The State of Health. Let’s step back a bit and talk about the real opportunity health care offers to Minnesota. In 22 states, the biggest employer is Walmart; in Minnesota, the biggest employer is the Mayo Clinic. In fact, five of the 10 largest employers in Minnesota are health care-related. Most national rating groups rate Minnesota the third healthiest state in the country.
Senior citizens (65 and older) are one of the fastest-growing demographics in the U.S.; AARP projects they’ll outnumber people under age 18 by 2030. That’s already true in some Minnesota counties, according to the recent census. Seniors have a growing amount of disposable income, and they also have a growing need for medical services. A business strategist viewing the strengths of our state and the growth of this very large market would see a flashing opportunity—we should become the State of Health!
This is, unfortunately, the political season, and we have a state governor (Florida) saying that his state is where things go to die. Our governor and subsequent governors should state that Minnesota is where people come to live. Slogans are empty without real financial support. Consequently, if we are serious about grabbing this opportunity, a new funding commitment and governance structure will be needed. The example of the Destination Medical Center is instructive.
Working out the details of a statewide commitment to become the No. 1 medical destination will require a great deal more of expert input. The current task force has made the first step in that direction. We should now embark on that journey. I may write to you again.
Yours for the State of Health,
Read more from this issue
Vance K. Opperman, a task force member
