Workers warn ‘bigger does not mean better’ when it comes to hospital mergers

Rachel Hanneman, an intensive care nurse at Fairview Southdale, led a press conference before a Capitol hearing on legislation that would give the state Health Department power to block health system mergers. “Their right to do business ends where our right to accessible health care begins,” she said.

Since M Health Fairview and Sanford Health went public with plans to merge last November, workers have emerged as a leading voice of opposition, warning that further consolidation would not benefit Minnesota patients or workers, only the CEOs already profiting off the health care system.

Members of the Minnesota Nurses Association and SEIU Healthcare Minnesota and Iowa spoke out at recent public hearings held across the state by Attorney General Keith Ellison, whose office is investigating whether the proposed merger complies with state and federal laws.

Union members also joined together with family farmers and medical students at the Capitol earlier this week to support legislation that would give the Minnesota Department of Health authority to approve or to block hospital mergers after a review of their potential impacts.

Opponents of the merger point to data suggesting that a wave of corporate hospital mergers across the U.S. has resulted in higher costs for patients and reductions to the services offered in local communities, but no improvements in the quality of care offered.

“Studies show that health care mergers have caused a 41% increase in prices with no evidence of improved quality of care,” MNA Executive Director Rose Roach said during a press conference before Ellison’s hearing in St. Paul Jan. 10. “What we need is public stewardship and oversight, holding the hospitals accountable to us, the public, not these independent, profit-making entities that focus on generating revenue.”

As for stewardship, neither Sanford nor Fairview has a track record likely to inspire public trust.

M-Health Fairview closed two hospitals in the middle of the pandemic, including the state’s only dedicated COVID-19 hospital. At the same time, CEO James Hereford took a 90 percent raise to more than $3.5 million in annual compensation.

Sanford, meanwhile, paid a $49.5 million golden parachute to disgraced CEO Kelby Krabbenhoft, who spread medical disinformation during the pandemic.

“Our state government has an obligation to pursue lower health care costs, better outcomes for patients and better conditions for health care workers,” Minnesota AFL-CIO President Bernie Burnham said. “This merger will do the exact opposite.

“As health care becomes more consolidated year after year, the only people benefiting are the CEOs. Now Minnesota’s regulators have a chance to draw a line in the sand and tell these regulators enough is enough.”

Rank-and-file union members, meanwhile, have raised concerns that the merger would threaten their collective bargaining rights and drive more health care workers out of the industry at a time when staffing shortfalls are at crisis levels.

Ericka Helling, an intensive care nurse at Fairview Southdale and a 25-year employee of the system, said she was “alarmed that a Minnesota institution could be bought and sold to an out-of-state entity.”

She noted that South Dakota is very different from Minnesota, where Helling’s union, the MNA, has a powerful seat at the table both in bargaining contracts and in oversight of the industry.

“Worrisome for me, as a union nurse, is what happens when an employer buys out a system,” she said. “Is our contract recognized? Do we need to fight all over again for the high standards and protections our contract provides the practice of nursing and patient care?”

M Health Fairview, Helling noted, refused to include language in its nurses’ most recent contract, settled in December, that would have extended the agreement’s terms through any merger.

Cliff Adams, an SEIU member who works at Fairview’s Masonic Children’s Hospital, echoed those concerns, and he called on Ellison and other leaders to focus on “the problems in our own backyard first and foremost,” including staff burnout, safety and racial equity.

“In the last four years we have seen our health care system strip away the caring aspect and monetize the health aspect,” Adams said. “We have seen failure from our employer. We are struggling to tackle these major issues with a large, home-based, Minnesota-oriented organization…

“Bigger does not always mean better.”

Union opposition helped tank a previous proposal to merge the two systems, forwarded in 2013.

Sanford and Fairview have said they hope to complete a merger by the end of this year.

The Attorney General’s office is also collecting public feedback on the merger online.


  1. Alice LaBarre says:

    Please do not merge U Fairview with Sanford. Sanford had behaved like a company that grabs and eats up everywhere it goes.
    Minnesota has a great reputation as a place for healthcare. We do not want SD and it’s politics coming into our state to eat up our good hospitals and clinics. As stated Bigger is not Better!!

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