The Milwaukee Post

8 • Milwaukee County Post • April 13, 2018 The grocery business in southeast Wisconsin is in transition with a major war between a number of companies looking to gain market share and drive out their com- petitors. This is to be expected, as all of the companies are for-profit organizations whose success depends on sales, revenue and profit. But the grocery war has nothing on anoth- er brass-knuckles battle for market domi- nance between some huge companies. Gleaming new facilities are being built, money-losing operations are being dumped, major corporate mergers are being announced and huge battles for dominance in high-dollar affluent neighborhoods are underway. All of this is going on in the local hospital and health care business and what makes it remarkable is that all of the com- panies call themselves "nonprofit." Ascension Wisconsin confirmed last week, after my exclusive scoop, that it is closing most operations at St. Joseph's Hospital, one of the last remaining hospitals serving the low-income Milwaukee north side. All inpatient and surgical services are being dumped and an emergency room and infant intensive care unit will be about all that's left. The hospital is a money pit because more than half of its patients are on Medicaid. The federal program for health care for poor people underpays the actual cost of care. St. Joe's doesn't have enough patients with private insurance to make up the difference. If Ascension were a for-profit company, its decision to essentially walk away from St. Joseph's would be under- standable. But Ascension is a nonprofit that gets special treatment because of an expec- tation that it acts in the public interest. State and federal law exempt nonprofit corporations from paying most federal taxes and most of the facilities are exempt from paying property taxes. These tax breaks are in place to encourage the existence of non- profits to fill in the gaps in our society that for-profit companies and government do not or cannot provide. There is an expectation that the nonprofits act in a benevolent way. There is nothing benevolent about any of these businesses. Aurora Health Care has set the standard by buying up physician practices and clinics and forcing doctors to send patients to Aurora's hospitals. Aurora recently merged with a large Illinois company and is now the tenth largest hospital company in the coun- try. Aurora has aggressively moved into booming neighborhoods with affluent resi- dents (and few poor people who are covered by Medicaid). The hospitals near Oconomowoc in western Waukesha County and Grafton in Ozaukee County were both built to move into well-heeled areas but also to steal business from competitors. ProHealth Care had a monopoly in western Waukesha County and St. Mary's dominated Ozaukee. Aurora smelled blood. Laggards like ProHealth were getting overwhelmed and their two measly hospi- tals in Waukesha and Oconomowoc were no match for Aurora, which was gobbling up Wisconsin. Backward management at ProHealth has since been replaced with more aggressive leadership and the compa- ny is fighting back, taking over clinic opera- tions all over Waukesha County. In Milwaukee County, national operator Ascension took over Columbia-St. Mary's right after it built a huge combined hospital on Milwaukee's east side. Ascension then gobbled up Wheaton Franciscan, which had operated St. Joe's. Ascension is one of the biggest companies of its kind in America. In the meantime, Froedtert Hospital expanded its alliance with the Medical College of Wisconsin by acquiring Community Health including the hospital in Menomonee Falls and now controlling two hospitals in booming Kenosha County. (Look for a hospital war in Racine and Kenosha counties to take advantage of the population influx that will come with Foxconn.) Where one of these companies goes, the others follow. Nobody is allowed to run a hospital without competition. Just like the grocery stores. In the meantime, poor people are being orphaned. Aurora still operates a hospital west of Marquette University and Froedtert has the area's only Level One trauma center to treat the many victims of violent crime that are brought in via ambu- lance from Milwaukee. But the downsized St. Joe's is the only other facility left. Here's the rub: The patients covered by Medicaid who had gone to St. Joe's will still go somewhere. Their piddling federal reim- bursements will drain the books of some hospital. If all of the St. Joe patients simply went to Ascension's Columbia-St. Mary's, it'd be a wash. So what was the point? Ascension is hop- ing those old St. Joe patients do not go to Columbia-St. Mary's. They are money los- ers. They want them to go to Aurora or take their red ink to a different non-Ascension facility. The desired customers are those with private insurance. That's why the new hospitals look like Ritz-Carltons and have great food, skylights and designer furniture. All of this is simply good business. But if good business, profits and market share are the sole purpose of health care companies. why do we even have nonprofits? For-profit companies must chase the bottom line. It's the reason nonprofits have to step in to do society's thankless jobs. But Wisconsin's nonprofit hospitals want no part of anything thankless. They want the money. (Mark Belling is the host of a daily WISN radio talk show. His column appears weekly in the Milwaukee Post. Send your personal correspondences to Mark Belling at Clear Channel Communications, c/o WISN, 12100 W. Howard Ave., Greenfield, WI 53228). MARK BELLING STANDING UP for MILWAUKEE 'Nonprofit' hospital companies chase profits OPINION Last week's question Major League Baseball is underway. How do you think the Brewers will do this year? Was last year a fluke or will they build on it? Or, what do you think of Milwaukee County Sheriff Richard Schmidt's suggestion of tougher first-offense oper- ating while intoxicated laws? Under Wisconsin statutes, the fine is $150 to $300 plus $435 OWI surcharge, a six- to nine- month regular license revoca- tion and no jail, which is increased to between a $350 and $1,100 fine as well as a five-day to six-month jail sen- tence, if a child under 16 is in the vehicle.The Legislature recently raised penalties for third and fourth OWIs. (Choose one.) It's about time they started getting tough on these drunk drivers. Sheriff Richard Schmidt says we need to get tough and I agree with him. One day you or your kid will go out and hurt somebody or kill somebody. You don't want that on your conscience, if you've been out drinking and driving. — Tommy Sukkert South Milwaukee *** In answer to how the Brewers will do this year, the Brewers' offseason acquisition of Lorenzo Cain and Christian Yelich will help. Unfortunately, it is not nearly enough to offset the erratic starting pitching and strikeout- prone offense. Unless we trade for starting pitching or find a starter or starters in the farm system, a .500 sea- son seems the best we can hope for. — Chester Skrobis Oak Creek This week's question What do you think of Ascension shutting down much of St. Joseph's Hospital on the North Side and any reduction at its St. Francis Hospital? Feel free to address Mark Belling's column. Or, what do you think of Da Crusher statue that is slated for South Milwaukee? (Choose one.) Editor's note: When responding to the Question of the Week, please include your full name with spelling, phone number and city where you live. Call 744-6370, Ext. 15 and leave a brief answer. Readers may also send an email with a brief answer to: dmuck@ conleynet.com. Question of the week Send your letters to: The Milwaukee Post, c/o Dan Muckelbauer, 3397 S. Howell Ave., Milwaukee, WI 53207, or by email to: dmuck@conleynet.com. We reserve the right to edit letters for style, length and clarity. Letters should be typewritten or printed and include full name, phone number and address. Please keep your letters to no more than 400 words. Letters policy

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