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There are discussions underway at the state Legislature that could dismantle our current primary service area (PSA) system for Emergency Medical Services (EMS).

For decades, this model has guaranteed everyone in Minnesota can receive 24/7 emergency care, regardless of their ability to pay. As an emergency medicine physician with Hennepin Healthcare, I've witnessed firsthand the stability this system provides. Especially as our EMS services undergo tumultuous events like COVID-19, staffing shortages and fluctuating reimbursement from payers.

The PSA system works because there isn't a patchwork of EMS services competing for the best-paying patients (and leaving others without care). Rather, there are set service areas that protect our broad community and ensure that no individual, community, neighborhood or rural area is excluded.

Some communities in Minnesota that do not currently own the ambulance licenses are interested in dismantling the current system. This move will destabilize our whole system — we can look to countless other states for proof of that. There can be more local input into EMS delivery without upending the whole system. Without the PSA system, I would expect our most vulnerable communities to get a significantly lower level of care. It would also open the door to gigantic corporations decreasing our current caliber of EMS.

In Minnesota, we're lucky to have one of the strongest EMS systems in the country. When someone in our state dials 911, they know they will receive quality emergency care. Join me in urging our elected officials to keep PSA laws intact.

The writer is chief medical director, Hennepin EMS.

If you've been following the public debate over the potential merger between Fairview Health Services and Sanford Health, you may have concluded by now that it's a bad idea. You might be wrong. Thirty years ago, I was in the middle of a significant health care merger in the Twin Cities that has turned out to be extremely successful, for both patients and employees.

In 1994, I was a physician leader at HealthPartners when we were contacted by St. Paul Ramsey Medical Center (now Regions Hospital). Ramsey felt that to thrive into the future, it needed to become part of a larger care system. We agreed to a merger.

A change of this magnitude was challenging, but over the next two years, we kept our focus on our intent to improve health care, provide more services and increase access. We were not uniformly successful, but we won much more than we lost. Regions has now become the anchor hospital for HealthPartners in St. Paul and far beyond. It plays a major role in medical education and research, as well.

We also hear that the University of Minnesota Medical School — from which I graduated in 1975 — would like to buy back its hospital from Fairview rather than entertain discussions with Fairview and Sanford leadership about how a partnership could better serve us all. This is a bad idea. Very few medical schools can successfully operate a hospital without a clinical partner like Fairview. The University of Minnesota learned that the hard way in 1997 when it was forced to sell its medical center to Fairview. What's changed since then that makes the U think it can now successfully manage a hospital? If anything, health care competition in the Twin Cities has become fiercer thanks to the continued evolution of organizations such as HealthPartners, Allina and Hennepin Healthcare. It's not likely that an independent U hospital would thrive in this market.

Jim Hart, Stillwater

In response to Cheryl Reeve's article "Court ruling is a powerful lift" (Opinion Exchange, March 2), I have just one question: How is it that she can write a lengthy article extolling the virtues of transgender persons competing with and against biological females in sporting events and not mention Caitlyn Jenner, the most well-known transgender person in the world?

Jenner has said in public, on more than one occasion: "I oppose biological boys who are trans competing in girls' sports in school. It just isn't fair. And we have to protect girls' sports in our schools."

And — as a former world-class athlete — she should know. Caitlyn Jenner, then known as Bruce Jenner, competed in the 1976 Olympic Games in Montreal and won the gold medal in the men's decathlon, an award which historically is presented to the best athlete in the world.

Make no mistake, Jenner shares and supports Reeve's concerns regarding many of the disparities in women's sports, but clearly understands that allowing men — who identify as women — to compete against biological females only compounds the problems of disparity and, in the long run, inequality.

Terry Bremer, Wayzata

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Reeve knows that in sports, males have always been privileged over females. Unfortunately, we as biological women are in the same situation in women's sports — biological males whose gender is female are privileged over biological females. I cannot imagine Reeve wanting a junior-high 95-pound girl wrestling a 120-pound boy and consider it a fair contest.

Biological males have physical advantages. I wish it weren't so, but there is no science to support the opposite. Is it so hard for some people to believe that there are many women who support and care for their transgender friends and still don't want them to compete in women's sports, where they have a physical advantage from being born male?

Judith James, Taylors Falls, Minn.

And, yes, you do have to offer some real leadership — something desperately lacking in Emmer's vacuous comments.