Yogi Berra said it isn't over till it's over. But in Rhode Island, the hospital regulatory game played by the attorney general's office relies on the opposite philosophy: It isn't started till it's started.
A strict Hospital Conversions Act enacted a few years ago forces merger partners to apply for a comprehensive evaluation that includes stiff and voluminous disclosure requirements. The law gives the attorney general 120 days to decide on the application once it's complete, but there's no time limit on deciding its completeness.
That's been the biggest factor in dragging out the time line for several merger proposals in the past few years. One deal was withdrawn by Tenet Healthcare Corp. after the application still wasn't complete after 11 months.
And now the definition of "complete" just got broader.
Antitrust issues frequently are the ballgame in state regulatory probes, but they just became part of the pre-game show in Rhode Island. In a 12-page letter to Lifespan Corp. and Care New England Health System detailing deficiencies in their conversion application, Attorney General Sheldon Whitehouse said the application can't be considered complete until antitrust implications are decided by federal officials and by his own office.
"The proposed transaction may change as a result of the antitrust review of the merger," the letter stated. "Obviously, we cannot now be certain that the initial application contains a detailed summary of the proposed conversion's post-antitrust review."
Maverick. Rep. Greg Ganske (R-Iowa), the Des Moines reconstructive surgeon who has made a career out of annoying his party leadership by taking opposing stands on some healthcare issues, is in the doghouse again.
Against the House leadership's wishes, Ganske released the text of a consensus managed-care reform bill that he had been drafting with fellow Commerce Committee members Charlie Norwood (R-Ga.), a dentist, and Tom Coburn (R-Okla.), a physician. Norwood and Coburn contended that the legislation was not complete and said Ganske was no longer involved in the negotiations. Commerce Committee Chairman Thomas Bliley (R-Va.) said Ganske had violated his trust, and health subcommittee Chairman Michael Bilirakis (R-Fla.) said he, too, had words with Ganske.
Ganske says he had decided to release the bill to press the leadership into action.
Ganske surrendered his seat on the National Bipartisan Commission on the Future of Medicare last year under pressure from the GOP leadership for co-sponsoring a managed-care bill with liberal Rep. John Dingell (D-Mich.).
Another trade show falls. So long, Atlantic City. After a two-year run, the New Jersey Healthcare Congress is history.
The seaside educational forum and trade show for Garden State healthcare workers debuted in 1997. It was supposed to fill a void created by the demise of its long-running ancestor, the Middle Atlantic Health Congress. But as interest in such "big tent" trade shows began to wane, hospital associations in Delaware, New York and Pennsylvania pulled out of the 48-year-old congress, leaving the New Jersey Hospital Association to sink or swim on its own.
The NJHA stepped up to the plate with a half-million-dollar production of its own. But after two years of break-even performance, it's throwing in the towel on even that event.
Members asked for a pared-down event, and that's exactly what they're getting. The NJHA will sponsor a one-day annual meeting and educational forum in Princeton later this month.
"In this environment, to expect people to get away for two or three days (is unreasonable)," concedes NJHA spokesman Ron Czajkowski. "People just don't have that kind of time anymore."
Calling Dr. Dangerfield. Doctors say they just want a little respect to help them cope with all the problems they face, so stop calling them "providers."
After all, who would respect a "Provider Zhivago" or trust a "Provider Marcus Welby," asks Thomas Saddoris, M.D., the author of a resolution approved by the Oregon Medical Association.
The physicians say the word "provider" is healthcare jargon they find demeaning, and their resolution urges hospitals and insurance companies to use the "proper, professional titles of either physician or doctor."
The OMA represents about 70% of Oregon's 8,500 providers, uh, physicians.
Healthcare tie. For John Alexander McMahon, former president of the American Hospital Association, and Anne Hall Davis, a former AHA board member, it was a match made in healthcare heaven.
On April 18, the two healthcare devotees tied the knot at a church in Durham, N.C., where they live. McMahon, 77, says he first met Davis, 76, in 1972 while he was AHA president and she told him the association needed more trustee involvement. Davis was a trustee for more than 30 years at Cape Cod Hospital in Hyannis, Mass.
Located in space. In cyberspace, you never know where your name will turn up next.
A case in point: Surfing the Internet one day, Outliers stumbled upon locator lists of U.S. hospitals in 32 states, complete with their latitude and longitude. Street addresses we can understand, but why the global coordinates?
The answer came-via e-mail, naturally-from the site's managers: Astrologers need to know where their clients are born.
According to Chicago-based astrologist Laurie Brady, however, hospital-specific information is probably overkill. For calculations based on place of birth, she says, "the city is good enough," and computer programs used by most professional astrologers provide those coordinates automatically.
Check out the list for your state at the World Wide Web site. The Web address you input must be tailored to your state. For example, if you want information on Texas hospitals, it would be www.interlog.com/birkej/states/Texas.htm.