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As health costs rise, Sanford spends

Dennis Millirons

FARGO - Sanford Health executives defended a new $360 million hospital during a public forum Monday night sponsored by Blue Cross Blue Shield of North Dakota.

The question, from an anonymous survey re­sponse, was how could health costs be controlled when Sanford was on a seeming building spree - and who would pay the bills?

Dennis Millirons, president of the Sanford Medical Center in Fargo, said the planned $360 million new hospital will make health delivery much more efficient, help to attract top talent, and help provide more health care locally.

Also, the downtown campus, which will include a revamped Roger Maris Cancer Center, is in an area that is subject to flooding. In a catastrophic flood, the breach of a dike could be devastating, Millirons said.

"We could lose the entire operation for months," he said. "Months. So we had to make some hard decisions."

Parts of the downtown medical center are more than a century old, no longer up to building code, and very inefficient, with narrow hallways. Old parts will be demolished, and an expanded cancer center will open a year or so after completion of the new hospital near Veterans Boulevard in southwest Fargo.

"It'll be a great resource for this entire region," Millirons said. "It will be the most modern, efficient facility that we can conceive of."

Paul von Ebers, president and chief executive of Blue Cross Blue Shield of North Dakota, said many medical centers around the state face the dilemma of dealing with aging facilities. If the medical providers build wisely, it could actually save money if it means more medical services can be provided in North Dakota.

Now, a fifth of medical claims are for services provided in Minnesota, in either the Twin Cities or the Mayo Clinic in Rochester, von Ebers said. Health care provided in North Dakota costs less than health care in those medical markets.

"We can't do everything in Fargo," von Ebers said. "But we can do more in Fargo."

The forum, one of a series Blue Cross Blue Shield is conducting around the state, gave policyholders a chance to ask questions or make comments - input that the insurer will use to help try to provide more affordable care, von Ebers said.

He pointed to blue penants hanging from the wall of the conference room at its headquarters and noted that affordability was first among the member-owned firm's goals.

The average family pays $1,000 a month in health insurance premiums, a quarter of a typical family's income, von Ebers said. "That's a lot, and we need to address that and try to keep that down."

Blue Cross Blue Shield and the state's medical providers are working to redesign the health system so doctors and hospitals are rewarded financially for providing better care, not providing more care. "We all agree we can do better," von Ebers said.

One man asked if different premium rates could be charged for smokers and non-smokers. Von Ebers said the new health reform law would allow that, and it's a possibility.

Similarly, some asked why married couples had to pay family rates. Actually, von Ebers responded, a middle-aged couple with no children actually can cost more to cover than a young couple with one, two or three children.

One man asked about the Canadian health care system. The Canadians do well in providing basic primary care and urgent care, but Canadians must wait for care that falls between those categories, von Ebers said. And Canadian health costs also are rising, he added.

Mike Martin of Enderlin said the session was valuable but predicted health costs would continue climbing by double digits. "It's not going to get cheaper," he said, noting six health systems provide most of the care in the state. "There's fewer players in the game."

Readers can reach Forum reporter Patrick Springer at (701) 241-5522