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Wrong Prescription

Region's Other Hospitals Question Costs, Economic Fallout Of Plan To Build New UConn Hospital In Farmington

March 11, 2007
Commentary By JOHN MEEHAN, and CHRISTOPHER DADLEZ

Connecticut's legislators will soon be asked to approve a plan put forward by the administrators of the UConn Health Center in Farmington to build a new, 57 percent larger hospital to replace 30-year-old John Dempsey Hospital.

At first blush this proposal would appear to be advantageous - who wouldn't want a brand new hospital in the Farmington Valley? But we represent five city hospitals - Hartford Hospital, St. Francis Hospital and Medical Center, Bristol, Middlesex and the Hospital of Central Connecticut - in saying that we hope the legislature and the public will look carefully at this proposal and consider the long-range impact it will have on our state.

Before lawmakers do anything else, they must ask whether 128 new hospital beds are needed in the region. Because a statewide study of health care resources and how they are allocated has not been undertaken in close to 20 years, the answer is that nobody knows. Half a billion dollars, the estimated cost of the proposed new hospital in Farmington, is a dangerous wager for such an undocumented "need."

Further, the legislature must question the wisdom of building an expensive new hospital instead of simply renovating the old one. Other hospitals, even those that are now centuries old, generally approach modernization with the care of a thrifty homeowner.

Let us not confuse Dempsey Hospital with the University of Connecticut Medical School, an institution of immeasurable value to our region and indeed the entire state. Here again an expensive new hospital seems unwarranted, because there are other models (Harvard Medical School comes to mind) where education takes place in area hospitals instead of at an on-site facility. As it is, the bulk of the hospital-based education UConn medical students receive comes from their rotations at Hartford Hospital, St. Francis and the Hospital of Central Connecticut. As one physician-instructor says, "You can't learn surgery in a library."

UConn's students are learning surgery and cardiology and women's health and internal medicine where the patients are - at the region's large, technologically sophisticated health care centers. Those medically rich environments provide a valuable aspect of their hands-on education.

A new John Dempsey is needed, UConn officials say, to support the perennially ailing Health Center itself. We do not share the confidence of some, however, in projections suggesting that a new hospital will require no additional taxpayer investment and will be "economically self-sustaining," let alone that it will be able to subsidize the Health Center's budget. The cost of providing care at John Dempsey Hospital is 16.7 percent higher than that of other hospitals in the region, a fact that does not argue for its expansion.

Hospitals around the state will soon be urging the legislature and the governor to increase Medicaid and State-Administered General Assistance reimbursement rates so that the dire situation facing us - and the neediest patients who are having a hard time finding a physician who will treat them at the state's drastically discounted rates - can finally be improved. We feel that this issue is at a critical stage and deserves immediate action. House Speaker James Amman succinctly characterized the issue this way: "With $280 million in the hole, this is not the year to be discussing [a new hospital]."

There is also the prospect, scoffed at by Health Center officials but very real to hospitals in nearby cities, that if a new Dempsey is built in Farmington, a shift will occur in the distribution of insured and uninsured patient populations. At a time when all hospitals are under financial strain, even a very modest shift in this patient population could have severely adverse financial implications for city hospitals and for the large numbers of un- and underinsured patients they currently serve.

If not a new Dempsey Hospital, what? We other hospitals have high regard for our colleagues at the Health Center and stand ready to work collaboratively with them and with care providers in the region to look at the problem and find creative solutions. The goal must be serving all the people of the state, improving access and allocating precious health care resources responsibly.

John Meehan is president and CEO of Hartford Hospital. Christopher Dadlez is president and CEO of St. Francis Hospital and Medical Center. This article was also signed by Presidents and CEOs Laurence A. Tanner of The Hospital of Central Connecticut in New Britain, Kurt A. Barwis of Bristol Hospital and Robert G. Kiely of Middlesex Hospital in Middletown.