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The Hennepin County Board is considering a takeover of the Hennepin Healthcare System (HHS) Board — a move that should alarm anyone who cares about the future of public health in our region. HHS operates a Level I trauma and teaching hospital, one of the most complex and critical institutions in Minnesota. It serves our most challenging and most vulnerable residents with clinical sophistication and compassion. County elected officials, while undoubtedly committed to public service, do not possess the specialized experience required to effectively govern such a sophisticated medical institution.
Let’s be clear: The problems facing HHS are not about governance. They are financial. Hospitals across the country are struggling under the weight of rising costs, workforce shortages and inadequate reimbursement rates. In Minnesota, the Legislature has expanded eligibility for public health care programs without providing reimbursement rates that cover the actual cost of care. This imbalance is unsustainable — and it’s pushing safety-net hospitals like HHS to the brink.
Instead of supporting the difficult reform measures proposed by the HHS board, the County Board has repeatedly blocked the hospital’s own efforts to implement long-term strategic changes aimed at improving solvency. These reforms were developed by experts who understand the operational and financial realities of health care delivery. Yet they were rejected by the County Board, whose decisions seem driven more by politics and division than by sound fiscal or medical judgment.
Now, the County Board wants to take full control. That’s not a solution — it’s a risk. Replacing a board of health care professionals with political appointees undermines the very foundation of HHS’s excellence. It injects short-term political interests into a system that requires long-term, stable and evidence-based leadership.
There are better options. The County Board should:
- Impose a one-year limit on direct involvement in hospital operations, allowing time for stabilization without long-term politicization.
- Collaborate with the HHS Board and health care experts to create a restructuring plan with measurable indicators of progress.
- Work closely with the Minnesota Department of Human Services to ensure transparency and maximize the full benefit of the Directed Hospital Payment Program to increase reimbursements.
- Improve its own financial transparency by clearly differentiating between claims, purchased services and the uncompensated care formula payments provided to the hospital.
HHS is not just another county department — it’s a lifeline for thousands of Minnesotans. It’s dominated by health care professionals committed to people and public service. Its future should not be dictated by political maneuvering. If the County Board truly wants to help — and I know it does — it should concentrate on advocating for sustainable funding models at the state level and supporting the experts who are already working to save the system.
