Lori Sturdevant: It's regrettable that U-Fairview talks have been so hush-hush

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Count me among the Minnesotans who smiled at news two weeks ago that the latest attempt to marry Twin Cities-based Fairview Health Services and South Dakota-based Sanford Health failed before they got to the altar.

Or rather: before anyone in South Dakota got anywhere near control levers at the University of Minnesota's medical enterprise. That was a plausible concern because, since 1997, Fairview has owned the university's teaching hospital.

But I remained annoyed about Fairview and Sanford's many months of hush-hush merger talks. And about the fact that the U and Fairview were still talking almost entirely behind closed doors about what's next for them.

That's why I smiled again on Thursday, when Gov. Tim Walz appointed a task force on academic health at the University of Minnesota. That ought to bring the question of how best to keep health sciences strong at the U into the public arena, where it belongs.

For almost a year, the future of a vital public institution has been hashed over by a handful of people with little direct public accountability. They've been largely shielded from public view or input, despite efforts by the Legislature and Attorney General Keith Ellison to remind them of their obligation — legally and morally — to serve the public interest.

That's not the Minnesota way to conduct public business — which this clearly is. U of M health sciences in general and the U's hospital in particular are public creations that matter greatly to this state, for at least three reasons:

• Education: If you seek medical care in Minnesota — from obstetrics to mortuary services and everything in between — chances are good that you'll see someone who was trained at the University of Minnesota. Nearly three of every four health care practitioners in this state, covering 30 professional fields, studied there.

To be sure, they don't all train at the university's on-campus hospital. But that hospital sets the standard for the rest of the facilities in which students learn.

• Direct care: You need not be dealing with a complicated, life-threatening condition to be one of the 1.2 million patients treated each year at M Health Fairview, the brand name given the university/Fairview clinical partnership in 2018. But if you are really sick, it's one of the best places in the nation to be. I'm among the satisfied customers who can attest to the value of the academic medicine practiced at the U.

• Research: The life-saving, industry-spawning medical research at the University of Minnesota is the stuff of legend — so much so that it's been featured in a Smithsonian exhibition about American inventiveness. Minnesota's vaunted medical device industry owes its origin and continued growth to university research.

In short, the university's medical activities are the wellspring of Minnesota's claim to be the "wellness state." That brand is so potent that a version of it was featured in Minnesota's bid for the 2027 World Expo, in which this state came in third to Belgrade, Serbia.

It's a brand worth fighting for – and paying for with the public purse, within means and reason. Determining what constitutes "means and reason" is now a pressing task, one that the new task force should tackle head-on.

Before the task force was named, I shared my irritation about all those closed doors with someone who, during the pandemic, became the very face of public health in this state – Jan Malcolm.

Walz evidently sees her that way, too. He tapped the recently retired state health commissioner to head the new task force.

Malcolm told me she too wants more openness now.

"This is of critical importance to a broad set of stakeholders," she said. She sees the university a central component of "a coherent strategic plan for meeting our health workforce needs and staying at the cutting edge of medical care."

With that plan must come adequate, sustainable funding. That's in doubt under the university's existing arrangement with Fairview, which during the first nine months of 2022 registered the seventh-largest losses of any health system in the nation, at $563 million.

But Fairview is not alone among this region's health systems in experiencing financial distress. No. 10 on the same list last year was Minneapolis-based Allina, which has since announced the elimination of 350 jobs. Meanwhile, the two health systems in Duluth, Essentia and St. Mary's, recently announced merger agreements with partners in Wisconsin.

Malcolm's task force ought to recommend ways to shore up what she calls "the broad health ecosystem," not just the university and Fairview.

"They've all been challenged to an extreme in the last few years," she said. "What did we learn from the pandemic, and what are we going to do differently as a result? This is complicated. It doesn't lend itself to quick, easy solutions."

All the more reason, I'd say, for Malcolm and her task force to swing into action.

Lori Sturdevant is a retired Star Tribune editorial writer. She is at lsturdevant@startribune.com.