Although Mercy Health System’s plan for a 128-bed hospital has not been submitted yet, it’s hard to see how enough has changed for it to be approved. Especially since opponents already have defeated it once.

Yes, the state regulatory board that permits or denies construction of new hospitals has different members. Yes, Mercy has increased the number of beds it wants in the hospital to meet state requirements. And although this is still Illinois, I hope we can assume there will be no elaborate kickback scheme involved this time.

But McHenry County Judge Maureen McIntyre had the final say on the plan last time. And she reversed the Illinois Health Facilities Planning Board’s decision to allow the hospital. Her ruling wasn’t based on the reports of corruption circulating in the newspapers, but because she found that the hospital proposal didn’t meet state criteria for approval.

Officials at Janesville, Wis.-based Mercy Health System say the hospital still would be built in the same place, at Three Oaks Road and Route 31 in Crystal Lake. Last time around, they said there were about 100 too few doctors in McHenry County, and that they could solve that problem.

But without major changes to state criteria for approval, or maybe a bombshell proposal such as building a high-level trauma center or burn unit that would eliminate the need for airlifting people elsewhere, it seems unlikely they’ll get the chance.

Documents submitted the last time Mercy’s proposal was being considered showed that there were six hospitals within a 30-minute drive of Three Oaks and Route 31. State criteria for allowing new hospitals say that they cannot be within 45 minutes of an existing hospital.

The companies that operate the nearby hospitals will object to the plan again. They will argue that it will duplicate services they already provide and create more competition for health-care workers, which will drive up health-care costs for everyone.

And having already fought this battle once and won, the opponents could make a strong case that if a hospital wasn’t needed in Crystal Lake two years ago, why should it be needed now?

Some people have said that they don’t think there is enough hospital capacity in this area. And many Crystal Lakers have long yearned for a hospital in their town.

jcoonen wrote on April 04, 2007 11:43 AM:"Eric, Eric, Eric...I shake my head...You want a "do-over" on this column? I mean, your approach surprises me. Since when did YOU, THEEE ERIC OLSON, buy into the idea that the State suddenly has the omnipotent wisdom to dictate what we citizens "need" let alone "want?" And since WHEN did NEED and WANT EVER truly matter when it comes to SERVING the FREE MARKET? I don't NEED another newspaper, I want it; so I buy the NW Herald and I'm better off for it. I don't NEED a Chevrolet, but Reichert's here in town to serve one up when I want it. I don't NEED a hotel, but Holiday Inn's right up the road when someone's visiting the house and WANTS a place to stay, away from my snoring (OK, maybe that IS a need, nevermind on that last one). Years ago, the CON process (in this case, "Certificate Of Need") may have been a good one, to protect hospital boards' collective rear-ends when Illinois NEEDED hospitals to serve us. Like a patent issued by the US Patent office though, after 17 years, they expire, and give COMPETITION a chance to move in on the original business (for- or non-profit, makes NO difference), which has had a more than fair head start. What we FIND in market economies, is that the strong survive and prosper - and often those strong competitors are lifted by the same rising tide; the marginal fall by the wayside. I'd say Centegra, with all its recent improvements and excellent leadership, is in a very strong position here in McHenry County, thanks to many great folks. Now, let's see how they compete on THIS SIDE of the river. I don't know about you, but any day of the week, any minute of my day, any time at ALL a progressive company with the ability to directly improve the health and welfare of my town, plus generate millions in new business, attract more careers and ancillary services without negatively impacting the environment with industrial smokestacks or crushing our infrastructure with 18-wheelers; AND (at the risk of formulating another run-on sentence) wants to invest a QUARTER-BILLION dollars in MY home town? I'm darn-well interested in hearing what they have to say - whether or NOT we "NEED" another hospital. I don't NEED a brain surgeon to tell me it's smart business to consider what this could do to positively impact our whole region. As I read my comments though, what is clear is that I DO NEED an editor. I apologize for another longgg post-so sue me. ;)"

elderslie wrote on April 04, 2007 1:03 PM:"I won't go so far as to say that Olson has hit the nail on the head, but he's on the right track when he says that the need for this hospital is miniscule as long as all it does it duplicate services that are already being offered in the area. A Level One trauma center would make it an attractive possibility, but it's not a realistic one. Same with a burn unit. Duplication of services, coupled with a serious shortage of qualified health care workers in the area severely weaken Mercy's case for building in Crystal Lake. The only exception I have to Olson's piece is where he talks about the criteria for building a new hospital being that there not be another hospital within forty five minutes. He should recheck his facts on this point, as presently there are plans in the works to build two new hospitals in Lake County. Advocate has approval to build in Round Lake, and the group that owns Victory in Waukegan is building in Lake Villa. Both of these new hospitals are well within a forty five minute (heck, make it twenty minutes) of a number of other hospitals."

PhelpsCommittee wrote on April 04, 2007 1:04 PM:"'atta boy John...Thanks for putting to words what is on my campaign weary mind. Have already reiterated the same comments directly to the Herald several times. Just not to Eric. The benefits a hospital would bring to our city are just phenomenal. And how 'bout we flip the question here. Dear Eric and my gentleman opponent: Can you explain why you don't agree with the "need" ?? And John, if you get sued, I know an attorney...but you might have to stop abusing the Park District to get his help."

jcoonen wrote on April 04, 2007 1:52 PM:"EO, you should post your response which you emailed me. Helps me understand your opinions with some valid points which I think readers would appreciate. "

ordinaryjoe wrote on April 04, 2007 2:02 PM:"Olsen, again you are way off here. The market should decide if another hospital is needed. Build it and they will come, as the saying goes. If the state can regulate hospitals, why don't they regulate banks the same way? Drive down near Randall and 62 and see how many banks are taking up prime real estate that could be better used by a business that will contribute something back to the community. We need a decent hospital in the SE corner of the county. Let Mercy build! "

jcoonen wrote on April 04, 2007 2:50 PM:"Elder, in my own experience, more and higher quality medical services are needed right here in McHenry County. Does Centegra deliver good services? Yes. Could it be better? Yes. Just like I could be better at my profession. In most cases, healthy competition helps make sure the good businesses do an even better job. Of course, the government has its CON guidelines, and a judge may have to make another ruling to determine whether Mercy's upped the ante enough...that in of itself is a good thing, no? However, the CON guidelines were established by the same state government that said tollways would be eliminated by now, lotteries would solve education's funding shortfalls and promised not to rob the teacher pension fund to pay its bills. They've got a little credibility problem with one Governor about to adorn an orange jumpsuit, and many wondering if there's a second one about to join him to complete the set of ironic bookends.Pulling out my Ronald Reagan quote-book, I'll share this appropriate truthism: "Government does not solve problems; it subsidizes them." "

jcoonen wrote on April 04, 2007 3:16 PM:"Phelps(es), I've felt this way a long time, but don't know whether it's actually a campaign issue--more of a red herring probably--as it'll likely by knocked down by the CON process. There are higher priorities than this right now, but it is great to have a place (NWH) to share concerns, hear ideas and go deeper than the headline or the short opinion piece. :::SIDEBAR:::My points about the Park District in other writings actually compliment our CLPD, but like many good things, I believe it should fold up shop. It served its purpose long ago, and is now best to be "rolled-up" INTO the municipality as a service, like other states. Townships too - roll-up into the County. Less is more. Less bureaucracy, less opportunity for graft, fewer staff, less long-term pensions, and best off: clear line of authority and more responsive programs because the BUCK stops at ONE government, not slip-slide among 2 or 3. :::END SIDEBAR::::"

Patriot wrote on April 04, 2007 3:27 PM:"Eric is all wet, methinks. The point he missed is that the hospital WAS needed 2 years ago and is still needed now, but archaic State approval processes (talk about Big Government!) made it impossible. How can anyone explain McHenry County's largest community, Crystal Lake, not having a hospital? In an emergency, you need to be driven to Barrington, Elgin, McHenry or Woodstock - good grief! Elgin has 2 hospitals, Aurora has 2 hospitals, Rockford has 3 hospitals, Crystal Lake has ZIPPO!"

elderslie wrote on April 04, 2007 3:30 PM:"ordinaryjoe, you can't compare hospitals to banks. The skillsets of the employees is vastly different. Any monkey can clip on a necktie and work the drive up at a bank. The qualifications are low and the supply of canidates is plenty. On the other hand, what good is a hospital if you don't have enough qualified nurses, doctors, technicians and therapists? The pool of quality health care workers is already spread thinly across the nation (especially in Illinois). Do you like the idea of visiting a hospital and receiving compromised care because the facility is perpetually short staffed?"

elderslie wrote on April 04, 2007 3:39 PM:"Again, the Phelps Committee can do nothing but parrot what they believe to be the need for a hospital in Crystal Lake is, without being able to articulate why it is so badly needed. They tell us, "The benefits a hospital would bring to our city are just phenomenal", but they aren't able to intelligently convey what those benefits might be. Typical Lori-speak, whereby she reiterates the themes of others' talking points, but can't substantiate them with logical arguments. Lori, do us all a favor and stay out of this discussion until you can bring something besides your political equivalent of cheerleading to the table."

PhelpsCommittee wrote on April 04, 2007 3:44 PM:"John, just to clarify, my comment was mine only and intended to poke some fun at your recent ramblings. I do believe your compliments may have been lost in your novel. Back to the hospital...yes, it is a campaign issue and the mayor himself made it one. His opinion of "need" is a biased one. Do I wish the mayor was not stuck between a rock and a hard place? YES. Now you can try all you want to convince me otherwise, but it's not just my opinion. I'm certainly not in this race for "me". I'm all for letting the community decide. Thanks for listening... Candidate Phelps "

elderslie wrote on April 04, 2007 3:48 PM:"Patriot, what's wrong with driving to Barrington, Elgin, McHenry or Woodstock if you have an emergency? An ambulance can get to a hospital in one of those places from just about any location in Crystal Lake, thereby negating your Rockford comparison. I visit hospitals in Rockford quite often, and can tell you that there are places in Rockford that are MORE than ten minutes from one of their three hospitals. The time to build a hospital in Crystal Lake has come and gone. It should have been done thirty years ago, when the alternatives for emergency care were Elgin, or DOWNTOWN Woodstock or DOWNTOWN McHenry. Now NIMC and Memorial are five minutes from CL's village limits, and the new Sherman campus will just be ten minutes down Randall Road. "

elderslie wrote on April 04, 2007 4:02 PM:"Just reread my last post and to clarify it should have read:..... what's wrong with driving to Barrington, Elgin, McHenry or Woodstock if you have an emergency? An ambulance can get to a hospital in one of those places from just about any location in Crystal Lake IN TEN MINUTES."

ordinaryjoe wrote on April 04, 2007 4:10 PM:"elderslie: I am well aware of the skill set differences. My point earlier was we have too many banks in the area and yet we keep getting more. Thats all. I happen to feel that we need a hospital at that location of Three Oaks and Rt.31. After visiting NIMC and the other one in Woodstock, I was unimpressed to say the least after experiencing terrific care at two different Alexian Bros. facilities. I wish they would build a hospital here actually. Good Shepherd isn't bad either. "

Patriot wrote on April 04, 2007 4:15 PM:"That is TEN MINUTES TOO LONG in an emergency, elderslie. If Eric (or one of his co-workers) collapses in the NW Herald office, he would probably rather be taken to a hospital at Three Oaks Rd and Rte 31 than Bull Valley Rd and Rte 31. There IS a need for a hospital in Crystal Lake and there is no real argument against it other than protecting the status quo of existing health care corporations. Sure, there is a shortage of staff - nurses, in particular - but that is not why the CON process exists."

elderslie wrote on April 04, 2007 4:45 PM:"joe - I'm glad that you understand the differences between banks and hospitals. Now use that knowledge to try to understand the specific point of my last post to you. Hint: Bank workers are a dime a dozen (a never ending supply to work in all of your banks). Skilled hospital workers on the other hand are scarce. There are barely enough to man the hospitals that we have now."

RamessesII wrote on April 04, 2007 4:54 PM:"A new non-Centegra hospital is needed in this area, if only to give Centegra employees a place to apply for positions, that will afford them better hours and other benefits. Take a look into cutbacks that have been made, and money that may have been diverted, in order to help pay for the new heart-surgery program where, at least one patient has expired on the table...."

elderslie wrote on April 04, 2007 4:57 PM:"Ten minutes is actually not too bad in an emergency situation. If you know any EMTs, ask one. I live in a town that has a hospital in it, and it would be roughly a ten minute ambulance ride from my home to the hospital. Do I believe that they should build another hospital closer to where I live? No. So what are you telling me with your example, that every corner should have a hospital on it so that people are never more than two minutes from an emergency room? That's not very practical is it? There WAS a need for a hospital in Crystal Lake (back in the days when the nearest ER was a fifteen to twenty minute ambulance ride), but that need can no longer be validated with an intelligent argument. "

elderslie wrote on April 04, 2007 5:16 PM:"And don't dismiss the shortage of nurses and DOCTORS as a legitimate concern. The trend isn't reversing, and may actually be getting worse. This brings to mind another difficulty with the Mercy group. As you may or may not know, Illinois is one of a handful of states that still puts no limit on awards to plaintiffs against doctors. That being the case, many doctors in higher risk/liability disciplines (OB/GYN, bariatric, etc.) are leaving the state or are regreattably limiting their practices to lower risk procedures. If you don't believe me, get off the interstate at the first exit in Indiana and have a look at all of the surgery centers that line that boulevard (full of Illinois doctors, by the way). Mercy is a Wisconsin based company. Don't you think for a minute that they won't be funnelling some of the higher risk procedures back to one of their Wisconsin facilities to reduce their own liability. Heck, they're already doing that to a certain extent up at their Harvard location. Two examples. Obstetrics (extremely high liability). I've heard that Harvard Mercy is doing all they can to stay out of the baby birthing business. Second example. Bariatrics (weight loss surgery). While Harvard Mercy has a Bariatric office on campus, it is used primarily for recruitment of patients, consultation and post-surgical follow ups. Many of the actual surgeries are being farmed out to Wisconsin locations. How do you like the idea of having to go to Wisconsin to get your healthcare? Now that ten minute ride to Good Shepherd, NIMC or Sherman doesn't sound so bad, does it? "

elderslie wrote on April 04, 2007 5:25 PM:"Ramessess - if only one patient has died on the heart surgery table at NIMC, then they're WAY below the national average. That's what happens to patients with advanced heart disease. Unfortunately, quite often they die. Would you also like to take NIMC to task when the next auto accident victim dies in their ER from sever brain trauma? What ever gave you the idea that positive outcomes in hospitals should be 100%? With that kind of thinking, it's no wonder that malpractice insurance for doctors costs so much!"

jcoonen wrote on April 04, 2007 5:33 PM:"Elder, If Mayo Clinic or the Cleveland Clinic was knocking on the door here in McHenry County, would you be so anti-for-the-sake-of-being-anti? What if they wanted in so bad, they made an offer to simply buy Centegra? Wouldn't that be fantastic? "

jcoonen wrote on April 04, 2007 5:46 PM:"Lori, I'll have to call you, sometimes these forums are hard to read the meaning, and seems we're not connecting. I'm glad Eric brought up this issue, as it's such a POSITIVE and slam-dunk "YES" for Crystal Lake and the surrounding communities that it's simply interesting as all get-out to hear the arguments against. Nursing is growing again; doctors are banding together to create new legislation to reduce lawsuits; and a hospital system is considering a quarter-billion dollar investment - not COST to the community, investment in US. They should just buy Centegra and call it a day. Wouldn't THAT beat all?"

elderslie wrote on April 04, 2007 6:14 PM:"Coonen, give me a holler when Cleveland Clinic, Mayo or Rush for that matter comes calling. Then we'll talk about your 'what ifs'. In the meantime, I'm not sure where your information is coming from, but nursing is not growing and the doctors have been working for YEARS to get the legislation changed with regard to caps on lawsuits, to no avail. Whether this is a "such a POSITIVE slam-dunk 'YES' for Crystal Lake" is questionable at best. It certainly doesn't do anything to improve the lives of anybody in the surrounding communities (a view obviously shared by the state licensing board). Question. Why are you so pro-Mercy? And I resent being called anti for the sake of being anti. I'm anti-CL hospital, because it doesn't make a whole lot of sense, and because NOBODY (including you or the future runner up in the next mayoral election) can seem to build a logical, compelling case for it. Make your case in favor. I'm listening. And don't start pulling shady factoids out of your hat. I've worked in the medical arena for more than twenty years. "

goodday wrote on April 04, 2007 6:29 PM:"I agree that Crystal Lake may not need a hospital that duplicates the services that the other hospitals provide. What Crystal Lake needs is a children's hospital, so we do not have to have our children go to Chicago or other far away hospitals for excellent care. It is hard enough for the child to be sick but when they are far from family and friends, it makes it that much harder on everyone involved. "

jcoonen wrote on April 04, 2007 7:15 PM:"Elder, Two words: "chill pill." I'm not pro-Mercy, I'm PRO MARKET-DRIVEN economy, PRO NEW CL hospital, and if you can't tell, ANTI-government over-regulation. The reason I asked you about Mayo/Cleveland Clinic was not to cause you to jump on the defense and have you read me your resume, or get into a nasty tangle which some folks simply tend to enjoy online; it was intended to isolate whether you are anti-hospital, or anti-Mercy. SO, which is it? You sound like some lobbyists I know so far. It really does Mayor Shepley no good to be derogatory toward his competition. I in fact have stated I support Mayor Shepley for Mayor. I believe Lori Phelps IS a real star for Crystal Lake, I respect her, and appreciate her willingness to step up. It takes strong character to do what she's doing, but Aaron's already proven he's worthy of another term. This issue isn't swinging me over."

RamessesII wrote on April 04, 2007 10:22 PM:"Elderslie, you missed the point. If, during the initial trial year of the heart program, one... patient dies, they could lose their program altogether. It might make sense to have a second hospital handy, which could possibly have a similar program up and running, just in case.... I hope yer heart is healthy enough to travel, in the meantime, should that prove necessary."

rnshusband wrote on April 04, 2007 10:28 PM:"the hospitals in the area can't staff enough nurse's now, so where are they going to find more?? If the hospitals were not full of illegal's getting there hospital stay on the working people of the state we would not need more room! "

Patriot wrote on April 04, 2007 10:50 PM:"So what if Mercy transfers some higher risk and specialty patients to Wisconsin? Many hospitals around here ship certain patients to Milwaukee for tertiary care. A hospital on every street corner? No. But a new hospital in Crystal Lake can only be a benefit to Crystal Lake, as it would be to any community that can sustain such an institution. There is a distinct anti-competitive, anti-innovative and pro-status-quo bias in the obsolete Certificate of Need process that protects existing health care corporations at the expense of potential new facilities. It is practically a franchise system that has less to do with controlling dubious "costly duplication of services" than it does with controlling competition. Speaking of controlling "costly duplication", an example of which shows how ridiculous the current CON process is, do we really need open heart surgery in both McHenry and Barrington (a mere 20 minutes apart, per elderslie), when most believe that surgical and nursing care of these highly specialized cases improves with volume, which would suggest that these cases belong in specialty centers that do high volume - such as Loyola or Christ. "

elderslie wrote on April 04, 2007 11:56 PM:"Coonen - FYI, I am anti-CL hospital, not anti-Mercy. But by the same token, if a hospital were to be built in CL, I think there are certainly better options fot the situation than Mercy (and not necessarily Centegra either). And kindly don't try to put a new spin on your original question. You never asked me previously if I was anti-hospital or anti-Mercy. What you asked was: "would you be so anti-for-the-sake-of-being-anti?" That's rather dismissive, don't you think? If you knew me, you'd know that I don't do anything just for the sake of doing it. "

elderslie wrote on April 05, 2007 12:12 AM:"Patriot, I take issue with your contention that "many area hospitals around here ship patients to Milwaukee for tertiary care." That simply is NOT happening. The only patients that go to Milwaukee are specific need patients who require care which is far more urgent and/or extensive than to be classified as "tertiary". I'm aware of trauma patients being airlifted from McHenry County to Froedert, because it is the nearest available Level One Trauma Center, in some cases. Such a Scenario will become less commonplace when Libertyville's Condell attains Level One status this year. The only other patients that I'm aware of being sent to Milwaukee on a frequent basis are the kids who get sent to the very excellent children's hospital up there. And just FYI, it does take only twenty minutes (give or take a minute or two) to get from Good Shepherd in Barrington to NIMC, if you take the backroads that run along the Fox River. 22 to Kelsey to Roberts to 176 to River to Bull Valley (Miller)."

chicken wing wrote on April 05, 2007 12:58 AM:"Dont worry elderslie, April 17th is almost here and we wont have to listen to any more of these silly ramblings. Mr. Shepley will win because he is the better canidate, period. Phelps will not win on just the hospital platform so this will not be a discussion after next week. Reelect Mayor Shepley!!"

elderslie wrote on April 05, 2007 1:17 AM:"I'm just glad that the state licensing board is looking out for the greater good of ALL the people who live in the area, rather than just what the folks in CL feel works best for them. "

My Opinion wrote on April 05, 2007 1:56 AM:"Has anyone been to a Centegra facility and had to be admitted? It is not uncommon for a patient to be admitted yet there are no beds available, so then spend a day or two in the E.R. because they have no beds upstairs. What frustrates me the most is that Centegra recently spent millions of dollars on upgrades to the E.R. (good) but also the exterior and lobbies of both Hospitals(Bad). They even had radio spots boasting of this "...and notice the umbrella stands as you walk into the lobby". They should have spent the money on more beds. It was a problem then and its a problem now...still! And has anyone noticed that many doctors left Centegra and signed on with Mercy? This happened years ago. Many of the good Doctors are now with Mercy due to the reputation they have. (I have never been to a Mercy facility for the record, just stating what I have heard.) There are still many good doctors and nurses with Centegra, but if I have a medical emergency today, I would rather go to Good Shepherd than Centegra. Bottom line...would a new Hospital in CL save lives when time is precious? Yes or No? Would a new Hospital put patients lives at risk at the other Hospitals? Yes or No? I will leave that for you to decide/debate."

elderslie wrote on April 05, 2007 7:39 AM:"Of course you'd prefer to go to Good Shepherd if you had a medical emergency! They just unveiled a brand new Emergency Services wing, that cost tens of millions of dollars and is now the gold standard in the NW burbs of what an ER should be. Do you think (considering the investment) that they might soon seek certification to become a Level One Trauma Center, like some of their other Advocate sister hospitals like Lutheran General and Christ? I think it's a possibility."

Patriot wrote on April 05, 2007 8:34 AM:"I really don't know why GSH (or Condell, for that matter) would seek Level 1 Trauma status. Prestige, I suppose is the only reason, since trauma is a notorious money loser for hospitals and generates an enormous amount of uninsured/unreimbursed cost. Of course, LGH is only 20 minutes away via Flight for Life."

jcoonen wrote on April 05, 2007 8:48 AM:"MyOpinion, bingo. The best way ANY hospital system can protect its turf is like any other successful business - be the undisputed best of the best. Best quality, best service, best people and yes - best price. That's easy to say, of course, since it glosses RIGHT OVER all the minutia of nursing shortage, medical lawsuit cap, and a myriad of other devil-in-the-details issues facing that profession, but bottom line is - and not to sound cold, but - that's not the citizens' problem. That's what executive teams are very well-compensated to do - design solutions to attract and retain the best of the best; get busy on forming legislation to GET LEGISLATION PASSED to put an end to frivolous lawsuits, and more. No, with all due respect, we can't solve the medical community's problems, but that is NOT the marketplace's concern. It's theirs. If THEY don't do it, perhaps there are OTHER health systems with the resources, the talent, the personnel and ideas to do it. One of those systems is knocking on the door now, with investment money in hand and and the gall to say they can make a positive difference here. I would like to see Crystal Lake better served than parking patients outside the ER, in drafty halls, waiting in pain for hours, with staff and strangers walking past them as if they're yesterday's laundry, while they wait--for hours--for a bed upstairs. This is NOT Walter Reed, nor should we allow it to become that way. THAT is our problem, and someone's got to solve it. If Mercy is denied again, don't be so surprised if they, or another medical provider doesn't continue knocking on the door. Good for us. "

katzenliebhaber wrote on April 05, 2007 8:52 AM:"There is absolutely no question that that collar-counties and Rockford are home to some of the finest hospitals in the country. Why is another needed in CL? There are as many reasons as there are medical emergencies and serious illnesses. My personal favorite is "Minutes Mean Muscle"."

ordinaryjoe wrote on April 05, 2007 8:54 AM:"You know, if Algonquin was smart, they would court Mercy or any other organization to build a hospital in their town and beat Crystal Lake to the punch. Plenty of room along the Randall Rd. corridor and besides we already have enough stores and chain restaurants, gas stations and banks there. So what solution do you propose to solve the shortage of skilled healthcare workers, elderslie? The healthcare industry, like any other in need of workers imports many of them. Look around and you'll see plenty of Filipino nurses in hospitals. I guess somehow we need to convince our young people to go into healthcare. The salaries are certainly good, but perhaps the schooling is too hard, too expensive, or just can't churn them out fast enough to keep up with demand. "

PhelpsCommittee wrote on April 05, 2007 9:54 AM:"We also need to look towards and plan for the future! Projections are that the population in this area will continue to grow. Our population is also aging. People are living longer. Baby boomers are becoming seniors. What's wrong with proper planning for the future health care needs of the people? Just as our city provides for our police and fire protection, they need to take all steps necessary to ensure that residents have accessible, quality health care that will accommodate the demands of our growing population. "

elderslie wrote on April 05, 2007 10:22 AM:"First, ordinaryjoe, apparently you are oblivious to the brand new Sherman Hospital mega-campus that has broken ground at Randall and Big Timber. It is a mere five minutes from Algonquin's southernmost border, and about ten from Crystal Lake's. Why in the world would Algonquin need to petition for a hospital and "beat CL to the punch"? Secondly, your solution for solving the healthcare worker shortage is so shortsighted and oversimplified that it barely merits consideration, much less comment. In short, very few people are cut out to work in the healthcare field. It takes a very special kind of person with an uncommonly unique set of skills. Healthcare is HARD work. It can be physically hard, mentally hard and gut-wrenchingly emotionally hard. Sometimes all at the same time. One of the challenges of solving the labor solution is not so much in finding people who want to get into the field, but rather, holding onto them once you have them. The attrition rate for healthcare workers is high. Many who thought they were cut out for the career, find that they're unable to sustain their enthusiasm for it (for any of a variety reasons), and eventually seek a different means of earning a living. Your question to me was, what my solution to the worker shortage would be. My answer to you is that I don't have an answer. I never suggested that I did have one, when I pointed out the shortage. I guess recognizing and identifying a problem are the initial steps in finding a solution to it, but the next steps are anyone's guess. I am certain, though, that presently, building more understaffed hospitals IS NOT an intelligent next step. "

elderslie wrote on April 05, 2007 10:49 AM:"Patriot - I'm shaking my head right now, trying to figure out your logic and why you state complete falsehoods as facts. Where did you get the idea that trauma patients are "notorious money losers for hospitals"??? While it is true that in general, ER's are bleeding red ink, it's certainly not due to trauma patients. Trauma patients are no more insured or underinsured than any other patient in the hospital. In fact, demographically, there is no truer cross-section of the general population of an area than the one represented by trauma patients. They are not defined by race, socio-economic means, age, gender or anything else really. Trauma patients are THE PATIENTS for which Emergency Rooms were originally designed!!! The reason that ER's have turned into money pits are because of most of the OTHER patients (mostly uninsured) who use the ER as you and I would use our Family Doctors, because legally they can't be refused services. The most recent estimate of costs that I'm familiar with suggest that the average cost to the hospital to initiate treatment to a patient in the ER is $250. That's $250 that walks out their doors everytime an uninsured person leaves after being treated for "flu-like" symptoms. Eventually some DO pay out of pocket. Most don't. On the other hand, trauma patients generally turn into a source of income to hospitals. Remember, that in general, trauma patients have the same rate of being insured as whatever the rate is in that geographical area. Trauma (violence, accidents and such) don't differentiate between the insured and uninsured. Many trauma patients, once stabilized are then admitted to the hospital for ongoing care, and this is where the money gets made. Insurance companies pay very well for services provided to trauma patients, and because treatment in the hospital can be ongoing for an open ended length of time, trauma patients turned admitted hospital patients provide the facility with a pretty good revenue stream. Now is it becoming apparent to you why it would be an attractive idea for a hospital to qualify itself as a Level One Trauma Center? It turns the ER from a cash pig to a department that financially sustains itself. "

Patriot wrote on April 05, 2007 11:32 AM:"Were it true, yes. Sad fact is that elderslie you are grossly mistaken regarding the economics of trauma care. Yes, yes, of course ERs are financial wastelands for hospitals and in no cases is the pit deeper than trauma care. If trauma care were the financial boon that you claim it to be, why are there so few Level 1 Trauma Centers and why would so many hospitals shun trauma 1 designation? Trauma does, in fact, discriminate socio-economically and you will find no higher proportion of patients receiving uncompensated uninsured charity care and write offs than that provided to trauma patients. The more hospitals spend on trauma cases, the more they stand to lose and the serious/critical trauma cases they admit put them the most at risk financially. Some see trauma as a financial boon because, when insured via work comp or auto insurance, it represents the last bastion of full price fee-for-service compensation. This, unfortunately, totally neglects the outrageous proportion of write off care, which is exceedinly expensive. "

Patriot wrote on April 05, 2007 11:39 AM:"Might I refer you to the National Foundation for Trauma Care "Trauma Center Crisis Report", with section headings that include "Trauma Centers Bleeding Red Ink", "Trauma Center Closures Accelerating" and "Diminishing Trauma Center Economic Viability"? http://www.traumacare.com/download/NFTC_CrisisReport_May04.pdfHow's that for a primer?"

ordinaryjoe wrote on April 05, 2007 11:49 AM:"Actually I had forgotten about Sherman's plans to build on that site, which I understand is going at a snail's pace due to legal matters and the main contractor walking off the job. It does sounds like it will be a nice facility though when it finally opens. "

Patriot wrote on April 05, 2007 2:20 PM:"Here is another to read, from the Journal of Trauma, called "An analysis of the critical problem of trauma center reimbursement": http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2072430&dopt=Abstract"

Patriot wrote on April 05, 2007 2:37 PM:"Lastly, this study concludes that hospitals lose an average of $25K per patient with a Trauma Score over 15 and that, thus, hospitals are better off financially to turf these patients to a regional trauma 1 center. In other words, local hospitals lose less money when they are bypassed and critical trauma patients are flown directly to a Trauma 1, such as LGH. This is not news to anyone familiar with the economics of trauma care. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=8656453"

elderslie wrote on April 05, 2007 2:41 PM:"Thanks for the link, Patriot. It's an interesting piece. Definite food for thought. However, nowhere in it does it come out and blame the actual trauma care for the red ink. It cites the uninsured, for sure, but doesn't distinguish between the uninsured trauma patient from the uninsured snotty nose who seeks their care at a trauma center. Keep in mind that actual trauma cases are not the only patients they see. They still get the same stream of uninsureds, illegal aliens and no pays as EVERY other hospital does, which is exponentially more draining due to the trauma centers inflated costs for trauma specialized personnel. Another interesting aspect of the article were the locales that they were using as case studies. Arizona, if I'm not mistaken. Trauma centers aside, whole hospitals (close to fifty, I believe) in Arizona have gone bankrupt in Arizona and California in recent years, mostly due to the burden of providing healthcare to uninsured aliens. Besides an inordinate percentage of illegal aliens seeking care in Arizona, they are also flush with senior citizens, and as the article correctly pointed out, Medicare is not exactly paying their share of the pie. Remember my point earlier about trauma patients being a pretty pure cross section of the general population. The table in that article bears me out. Approxiamtely 87% of patients with actual "trauma" were injured under circumstances that were not unique to their "lifestyles". Only the ones listed under ASSAULT (gunshots and stabbings) would be ones where you could pick out the socio-economic situation from which the victim came. The other categories: Motor Vehicle Crash, Fall, Burn, Rec Accident, Other Accident and Suicide are all circumstances to which ANY person could fall victim, without regard for insured status. And to point, as interesting as the article is, it really doesn't speak specifically to the scenario that I painted in my previous post. It has more to do with the increassed need for Trauma Centers in post-911 terroristic America. From that angle it decries the fact that Trauma Centers have been closing due to financial reasons. Again, it doesn't necessarily blame the actual trauma cases for being the cause. I'll meet you halfway on this one and call us both half right on this issue. I'm going to dig into this a little further, and see if I can come up with some more local and more recent data. I have to tell you, though, that most of the information that I conveyed in my previous post were things I've heard from a number of close acquaintances who work in Emergency Departments both at hospital and system level in the Chicago area."

elderslie wrote on April 05, 2007 3:03 PM:"I read the second article, as well, Patriot. Another interesting article, but the data was culled only from "rural" hospitals, not to mention the fact that it was written more than ten years ago using data that is probably now fifteen years old. Rural and urban areas tend to have a substantially higher rate of uninsureds, than typical suburban areas like ours do. This being the case, it's not surprising the high dollar average losses per patient that the rural hospitals were incurring. "

jcoonen wrote on April 05, 2007 3:38 PM:"Some background for you----Link to the State's certificate of need (CON) process overview, which requires three affirmative votes to pass: http://www.idph.state.il.us/about/conprocess.htm and link to the actual 127-page CON process, a http://www.idph.state.il.us/about/hfpbmembers.htm and a link to a PDF copy of the letter of intent http://www.idph.state.il.us/about/hfpb/pdf/Letters%20of%20Intent/2007-03-30%20LOI-MERCY%20HOSP%20&%20MOB%20CRYSTAL%20LAKE.pdf "

jcoonen wrote on April 05, 2007 4:04 PM:"Cursory research on the CON process, as I was wondering what politician came up with the "fuzzy math" to believe a State Commission could actually achieve the mission of "reducing costs and increasing efficiency" of the health care system. This, from the Citizens for the National Capital Medical Center: #1: The CON process was imposed by the Federal government via the National Health Planning and Resources Development Act in 1974-an attempt by Congress to reduce national health care costs. This Act was repealed in 1986 because lawmakers found that this mechanism failed to effectively control skyrocketing health care costs. "

jcoonen wrote on April 05, 2007 4:05 PM:"#2: Since that time many states have reduced or completely eliminated their CON programs. * 14 states do not have a CON process at all * 4 states have limited the CON process to no more than two services. * 8 states do not mandate CON for acute care or ambulatory surgical centers. * Projects in these 26 states are eligible for FHA funding and are not required to produce a certificate of need. "

jcoonen wrote on April 05, 2007 4:06 PM:"#3: The Federal Trade Commission and the Department of Justice issued a report in July 2004, based on a series of 27 hearings and workshops with experts, which recommended that states reconsider their CON process on the basis that it does not control health care costs and is used by market incumbents to create barriers to competition. The American Medical Association also took an official stance in December 2004, encouraging states to limit the use of the CON process."

patriot wrote on April 05, 2007 4:39 PM:"Fair enough, elderslie. But I am curious how the financial managers at Condell over in affluent, suburban Libertyville will react when their Trauma 1 Center begins receiving critical trauma cases from the relative inner cities of Waukegan, North Chicago, Zion, etc.... "

jcoonen wrote on April 05, 2007 4:47 PM:"Government should simply set the boundaries and requirements and enforce them when/if a hospital does not comply with the law. It's not enough for legislators and their bureaucratic power base to adore REGULATION; nope, they up the ante when they reach into the fetal stage of a hospital's life - the planning phase - and PRE-regulate. Whether or not CL gets a hospital, the ill-conceived CON process is nothing more than an elaborate and expensive dance between lobbyists, lawyers, administrators and bureaucrats (think Department of Motor Vehicles on steroids) and guess who pays for it all in the end? Not ONLY entrepreneurs in the medical field (both for- and non-profit), but ultimately we do. And please, somebody, ATTEMPT to convince us all that the federal law of 1974 which first provided for the establishment of this PRE-regulatory "CON" has been effective at achieving its stated mission of "controlling skyrocketing costs" and "increasing efficiency." By the way, you know a big cause of the nursing shortage which started in 1999-2000? A shortage of NURSING INSTRUCTORS! All the money saved on NIXING the CON process could be used to underwrite the ramp-up of a local nursing program. Let's get MCC and Columbia on the stick to ramp their programs up and voila! ANOTHER FANTASTIC solution, bringing more career opportunities within the boundaries of Crystal Lake. "

katzenliebhaber wrote on April 05, 2007 5:51 PM:"Are you guys serious? Talking dollars signs when the only legitimate reason for any medical facility to exist is to save lives and alleviate suffering?"

My Opinion wrote on April 05, 2007 7:52 PM:"Is anyone aware of the rumor that Centegra is looking to build a Hospital on the pumpkin farm property on Rte 62 in Algonquin/Lake in the Hills/Huntley area. I think its called Dons. Centegra is going to build another Healthbridge facility there and is tinkering with a possible Hospital there. Take this only as a rumor. "

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