In its recent assessment of the Mayo Clinic’s treatment of the hospital in Albert Lea, Minn., the Star Tribune Editorial Board makes several great points — Mayo’s heavy-handed pronouncements to stakeholders and the community leave much to be desired, and its decision to eviscerate the only hospital in a sizable rural community calls into question Mayo’s commitment to our state and rural communities (“Is Mayo living up to Minnesota mission?” Aug. 26). But the Editorial Board misses the bigger issue: a seismic shift in our nation’s health care system from a patient motive to a profit motive. Mayo’s treatment of Albert Lea, especially in light of a $585 million taxpayer commitment to Mayo’s priorities, is simply the latest case study.

First, it’s important to note that the Mayo-owned Albert Lea hospital is not hurting financially. To the contrary, the facility pulled in $12.3 million in net profits over the past two years for which financial disclosures are available. Mayo would undoubtedly argue that, like all hospitals, some of its income came from grants and investments that should not count toward the bottom line. However, this argument fails to pass the sniff test — try telling it to the IRS, which specifically requires income to be reported as income.

Second, it’s far past time to dispel the myth of the struggling rural hospital. The Affordable Care Act has been a huge boon to hospitals of all stripes across the country as the rates of uncompensated and charitable care have decreased. A Minnesota Department of Health study found that Minnesota hospitals experienced a 12 percent decrease in uncompensated care costs in 2015 alone, saving hospitals across the state $37 million. These numbers have continued to improve as the rate of uninsured Minnesotans has continue to decline. And rural hospitals have been a main beneficiary of this trend. One recent study found that rural hospitals in Minnesota and surrounding states grew profits by 15 percent between 2014 and 2015, increasing net income to $1.25 billion. This coming on the heels of a 22 percent increase in 2014 outstate hospital profits.

Last, it’s important to note that improving the quality of care for Albert Lea residents is a dubious explanation for this change. By all accounts, Albert Lea residents aren’t asking for it and are happy with the high quality of care already being provided in their community. Furthermore, a comparison of Medicare data from the Albert Lea and Rochester facilities shows that Albert Lea is at least equal in the vast majority of quality-of-care indicators. Ironically, Albert Lea outperforms in measures ranking pregnancy and delivery care — but will soon see its labor and delivery services outsourced.

Given this information, one might be tempted to disregard the profit motive as a main driver behind the change. Unfortunately, it’s still the most likely explanation. As we’ve seen in this state, the trend in health care is consolidation, and using rural hospitals as feeders to large moneymaking institutions has proved exceedingly effective in supercharging profits. Mayo has already shown its hand on this front: Consider CEO John Noseworthy’s statements that Mayo prioritizes privately insured patients over Medicare patients, its zealous pursuit of outsourcing any unionized sectors within its vaunted clinic and its pursuit of a $585 million taxpayer handout in a year that it posted $503.1 million in net income.

But Mayo would do well to remember the immortal words of its founding brothers — “the best interest of the patient is the only interest to be considered” — and abandon its shortsighted effort to pursue profits at the expense of Minnesota and its rural communities. Minnesota deserves better.


Mathew Keller, of Inver Grove Heights, is a nurse and attorney who works for the American Nurses Association as a senior policy adviser. The views expressed here are his own.