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Tough task for health care


We don’t envy the challenge that Barb Nervig and her five colleagues at the state’s Health Facilities Council are facing regarding the hospital issue in West Des Moines.

Iowa Health-Des Moines has announced plans for an $80 million, 83-bed facility. Tucked into a sweeping $186 million construction and renovation plan from rival Mercy Medical Center is a proposal for a $36 million, 40-bed hospital across the street.

Amid the dazzle, it’s tough to see a solution that will leave all parties involved, including citizens, politicians, businesses and the hospitals themselves, a winner.

Iowa Health and Mercy argue that population growth in Des Moines’ western suburbs is driving the need for more comprehensive medical services there. A hospital (or two) closer to those citizens would no doubt be convenient for some, and might even save lives.

On the other hand, health-care costs are skyrocketing. John Forsyth, the chief executive of Wellmark Blue Cross and Blue Shield, has become the standard bearer for the keeping-costs-down crowd. Building new hospitals is an irresponsible way to improve health care given current price hikes, they say.

The problem Nervig and the council face is in choosing which health-care provider, if any, is granted a license to build in West Des Moines. There is a great deal of uncertainty here, not just about whether Iowa Health or Mercy ought to be given permission to build, but whether the council has the authority to grant that permission.

Mercy, whose proposed site is in Polk County, doesn’t think it needs state approval. Iowa Health, whose land is across the street (and across the county line), apparently will need the council’s blessing.

There is little chance that either hospital group will wither if barred from building a major facility in West Des Moines. However, such a ban would prevent them from doing business in a potentially lucrative market. The irony that federal and state laws designed to preserve competition could actually end up preventing it is not lost on us.

In this vein, Mercy could conceivably go ahead with its plans. The council, seeing needs for a hospital in West Des Moines met, could deny Iowa Health permission.

Surely this situation was not foreseen when the state’s certificate of need laws were written. It is here nonetheless, and it will have to be untangled. In this sense, Nervig and the council have a chance to play kingmaker.

Amid the hype that is sure to be presented in the coming months, the council’s challenge will to stick closely to it’s mission and carefully weigh what additional health-care facilities, if any, are truly needed.

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