The Road To Sprawlville, Chapter XXIX: At The Intersection With Health Care Rationing
Those of you who drive on our costly 'free'way system have perhaps seen both the Aurora hospital about to open in western Waukesha County at Pabst Farms, and another brand-spanking new Aurora facility underway just off I-43 in Ozaukee County just west of the Grafton exit.
Total cost for both: more than $260 million.
Yes, this is the same Aurora that dominates the regional market in southeastern Wisconsin, where health care costs are far above national averages - - and where Madison, without Aurora, but with a successful big health care co-op, has the lowest costs.
So what does all this mean?
For one thing, it means Aurora continues to build facilities farther and farther from its downsized Sinai campus downtown, which is the lone surviving hospital in the downtown - - thanks to government decisions to promote the County Grounds as a new so-called regional hospital complex.
Another example of "regional" meaning "not Milwaukee."
That flight out of the downtown sent Children's Hospital to Wauwatosa, where the suburban medical cluster took shape, and, as do other Aurora expansions, carry jobs and spin-off developments with them while low-income residents and patients are left behind in the City.
New facilities cost tons of money, yet does anyone believe the Aurora hospital at Pabst Farms will really trim through competition the cost of a mammogram or brain surgery because Memorial hospital is in Oconomowoc three miles away?
As coverage and expenses escalate - - remember, all these facilities must advertise, and invest in staff, training and equipment - - people respond to their rising billings by cutting back on procedures, prescriptions and other services: call it rationing imposed by a distorted marketplace that keeps Aurora profitable and growing its control.
Of course, these new facilities could not or would not locate in once-rural Ozaukee or Waukesha Counties if the state wasn't widening with public funds the 'free'way system right past their front doors.
The Road To Sprawlville has more costs - - social and financial - - than mere highway construction, land loss and air pollution.
[Note: I misnumbered this chapter. It should have been XXX. So the next installment, for those keeping score, is XXXI.]
I have my doubts about whether Aurora will continue as a viable megacorporation.
Twenty years ago, an old line and well endowed Wisconsin social agency, Lutheran Social Services, under the benighted Leadership of a "builder" began expanding through building and acquisitions.
The disastrous purchase of real estate--the former DePaul Hospital, which had gone belly-up trying to serve clients with mental health and substance abuse problems via lots of inpatient treatment--put an end to lots of dreams of "getting big".
One of the former LSS financial professionals (who fled before the deluge) gave his dictum for health and social service agencies that have a lot of mortgaged real estate.
"You expect to have fluctuations in revenue, so you build-in a cushion:
"A month with revenue/admissions/patient-days down is not problem... Two to three months causes some pinching...More than that, and you're toast."
Aurora--and lots of other health care organizations--have built freely and extravagantly over the fat years of the past decade. The push to have Aurora's state-of-the-art digs in Summit was driven by the waves of upscale sprawl expected to follow Pabst Farms (speaking of TOAST)to the outer reaches.
The growth is permanently stalled, Aurora Summit is scraping to find cash to finish and have a grand opening.
If they had a lick of sense, they'd abandon it.
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