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Health care in Minnesota used to be about taking care of one another. Local care providers, grounded in our communities, worked hard to build up Minnesota’s reputation for excellent care. But highly paid executives with corporate agendas have taken over our health care system, and the results have been disastrous. What is happening right now in the northwestern city of Fosston is a dire warning for patients, workers and communities across the state about the creeping influence of corporate greed in our hospitals.

When the Fosston Hospital joined Essentia Health in a strategic partnership in 2009, the financially stable hospital had been providing exceptional care in the community for more than 60 years. Community leaders recognized the risk a large corporate entity posed to the 15 rural communities and 20,000 people who depended on the hospital, so Fosston negotiated hard and won an agreement to guarantee that the services rural people relied on would always be there, including birth care.

The agreement held until May 2022, when the city learned that Essentia executives were planning a 120-day pause of scheduled births. Fosston formed a task force of local community stakeholders who worked hard to meet the standards set by Essentia to reopen labor and deliver services. More nurses were hired, despite the challenges of short-staffing and moral distress from the pandemic. A third family medicine obstetrician was hired. Staff were trained, no thanks to Essentia executives, but to local hospital staff.

Despite this success, Essentia executives continued to move the goalposts, and it soon became clear that they had no intention to end the “pause” of birth care. Having labor and delivery services in the community means expectant parents don’t have to drive hours in the harsh Minnesota winter when they are desperate to reach the hospital for scheduled or emergency care. It also means attracting and retaining residents in Greater Minnesota, where young couples expect to find care they can count on. But on some spreadsheet on a desk at Essentia headquarters, some executive saw a bigger bonus in their pocket if they drew a red line through the heart of this community.

The actions of Essentia in Fosston follow a clear course set by the CEO and other executives at the hospital system. After nurses represented by the Minnesota Nurses Association (MNA) won new contract language in 2022 meant to include nurse voices in the process of setting staff levels, Essentia instead slashed staffing when it opened a new hospital in Duluth last summer. Just a month later, Essentia closed urgent care services in a nearby rural community. Essentia executives recently utilized an emergency alert system — meant to warn employees about active shooters and natural disasters — to spread anti-union messages to care staff trying to come together to bargain collectively. And during the pandemic, Essentia executives put 500 staff members on “unpaid leave” while CEO David Herman gave himself a $1 million raise, to now take home more than $3 million per year.

As former Fosston Hospital administrator Pat Wangler put it at an emergency meeting about this service closure last fall, this is about one thing: “greed.” Labor and delivery services are not a moneymaker for corporate health care systems, and so executives put them on the chopping block. Essentia is not unique in this regard. Mayo Clinic executives recently announced similar plans to end baby delivery services in New Prague. In 2022, Allina Health executives shuttered birth care at Regina Hospital in Hastings. After Fairview purchased the HealthEast system in 2017, executives there closed the doors on two hospitals providing care to underserved communities in St. Paul at the height of the pandemic.

When these large health care corporations come into small, rural communities, they often present themselves as the only hope to keep a struggling health care system afloat. But all too often after being “rescued,” we see the same facilities and services closed down anyway; the only difference is the fat bonus in the pocket of corporate executives after they sell off our hospitals for scraps.

Fosston’s experience shows clearly that these decisions by hospital executives are about nothing but the bottom line. We need to return to a health care system that serves patient needs, not corporate greed.

Cassie Heide is the Fosston city administrator. Chris Rubesch is an RN at Essentia Duluth and president of the Minnesota Nurses Association. For more on this issue, see the Feb. 4 editorial, “Worthy battle to keep hospital birth care.”