Medical district picture changes

By The Gazette Editorial Board

Collaboration or territorial competition? It appears the latter still rules among major health care players in Cedar Rapids.

Mercy Medical Center announced Thursday that it will build its own cancer treatment center in the emerging medical district instead of a joint facility that Mercy, St. Luke's Hospital and physicians discussed for two years. Physicians' Clinic of Iowa, which wants to build a medical mall in the district, and St. Luke's officials both expressed “disappointment” about the news.

The medical mall was intended to anchor development of the city-endorsed medical district, with St. Luke's and Mercy hospitals as bookends. Both hospitals voiced support last fall and we have, too. The medical mall and district could advance coordinated care and convenience for patients, while spurring economic development by becoming a medical destination.

Mercy's decision raises serious questions about the medical district's direction:

l PCI already offers, and plans for its mall, many cancer treatment services. Would PCI's project and Mercy's cancer center bring needless duplication that may drive up costs?

l Does the PCI project warrant major taxpayer support? Non-profit Mercy is funding its project without any public assistance. For-profit PCI wants closure of two blocks of Second Avenue and public assistance toward a parking ramp and additional costs of building in the district instead of elsewhere. The City Council in January gave unofficial support to an estimated $10 million in incentives, but hasn't taken a stand on the street closing, which would add several million in related costs and is on Tuesday's Council agenda.

We have supported closing Second Avenue. We believe the retail-style mall would benefit patients and the local economy, building synergy with nearby cultural districts.

Nonetheless, the City Council, facing many near-term financial challenges, should critically re-evaluate how much public assistance, if any, should be approved for PCI. As it stands, much of the assistance would come from directing new property taxes generated by the project toward cost of the parking ramp and some infrastructure improvements. However, the downside is that the city cannot use the additional tax revenue for other things until those costs are paid off a decade or two from now.

The council must carefully weigh the benefits vs. taxpayer risk before making a final decision on all of PCI's requests. Why assist PCI and not Mercy? What about future medical district developments?

And how about that collaboration on cost-control and quality strategies that our hospitals' CEOs have often trumpeted during the past year? The collaboration recognized nationally by the Institute for Healthcare Improvement as key to our high-quality care at below-average costs?

Does that collaboration still exist?