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As I read Dr. Peter H. Kelly's piece on the Fairview/Sanford merger proposal ("What's really at stake with the Fairview and Sanford merger," Opinion Exchange, Feb. 20), one thing that struck me — as it has previously when reading other material on this subject — is exactly why Sanford is (apparently) in so much better financial condition than Fairview. According to Kelly and others, Sanford has invested many millions in rural health care systems in the Dakotas and parts of Minnesota such as Bemidji, and yet it is financially strong enough to be able to prop up Fairview after the merger would be complete — including the continuation of Fairview's yearly support of the University of Minnesota Medical School. In comparison, the Fairview system has lost hundreds of millions in recent years — and without the merger, the losses are projected to continue, apparently with no end in sight.

Why such a stark difference between the fortunes of these two large health care organizations? Is it mostly due to the donations of billionaire Denny Sanford, which Fairview lacks? (And if so, then whenever Denny Sanford's money is used up, does that mean the merged Sanford/Fairview would start running big deficits?) Is the general business plan of Sanford that great, and/or the business plan of Fairview that poor? Or is Sanford operated that much better than Fairview? Certainly the median income of Fairview's customer base must be higher than that of Sanford's, given that Minnesota's median household income ranks above both South Dakota and North Dakota.

I think Fairview's bosses should be required to give believable answers to some of these questions before the merger would be allowed to continue, and before Minnesotans would be expected to turn over a good-sized chunk of their health care business to a South Dakota-based company — including quite a bit of the funding for the facility that trains a heavy majority of the doctors who serve Minnesota.

John Ewan, Falcon Heights

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We appreciate the opportunity to respond to the opinion piece by Dr. Peter H. Kelly. We feel compelled to address several points. First, Kelly expresses surprise that the university is expressing opposition to the planned Sanford acquisition of Fairview as it is currently presented. Yet the proposed plan does not have a commitment to the university's mission in this Sanford-led organization beyond, "We will figure it out later." Additionally, it must be remembered that, despite an existing joint agreement between Fairview and University of Minnesota physicians, Fairview engaged with Sanford regarding an acquisition for several months and drafted a letter of intent prior to the university having any knowledge of the discussions. This was an unfortunate decision that resulted in loss of trust.

Second, Kelly alludes to the funds that are transferred to the university each year as a contributor to Fairview's losses. Again, this statement leaves out the critical data that Fairview agreed to this commitment and that it is in line with most other academic health centers. In addition, Fairview had already experienced a steadily decreasing net operating income for several years without clear corrective action before beginning contributions to the university. Thus, the funds used to support the university (as is typical nationally) must not be used as a scapegoat for deep operational issues that are associated with Fairview's losses.

Furthermore, these funds have been invested in the university's academic and research programs. This investment helped increase the university's grant funding from the National Institutes of Health, lifting us to No. 8 in the nation among public institutions. This increase in NIH research funding is a great boon to the state of Minnesota and something in which all Minnesotans can justifiably take pride.

Lastly, we appreciate that Kelly acknowledges Fairview's financial woes as the main driver of the potential Sanford agreement. This has created urgency in acquisition talks that amplify the risk to health care of Minnesotans. There has been much talk about the Sanford agreement leading to lower health care costs but multiple sources of data demonstrate that mergers/acquisitions do not lower health care costs, they raise costs. Thus, Fairview's contention that acquisition by Sanford will lower costs is misleading at best.

We agree that it is worth considering what would happen if Sanford does not acquire Fairview. Regardless of that outcome, the University of Minnesota maintains a mission and duty to serve the health of the region. Any future agreement between Fairview and Sanford must come with a guarantee of long-term collaboration in this mission. The university must continue to oppose until such plans can be made.

This letter was signed by University of Minnesota School of Medicine faculty Dr. Samir S. Khariwala, professor and chair, Department of Otolaryngology-Head and Neck Surgery; and Dr. John R. Fischer, professor and chair, Department of Obstetrics, Gynecology & Women's Health.

The East Phillips Urban Farm is a model for environmental justice in heavily polluted neighborhoods that can be replicated citywide, statewide and nationwide. If what is happening in East Phillips were happening somewhere else we would frown, call it an injustice and condemn the situation. Why won't Minneapolis do a cumulative environmental impact statement? Why?

As a society, we are willing to work to better some situations, like airport and freeway noise abatement. But we burn garbage near north Minneapolis, home to a large minority population. The city's plan, which will add heavy daily diesel pollution to the East Phillips neighborhood alongside the arsenic problem, violates the Clark/Berglin law, a state environmental-justice law that requires municipalities and incoming industry to consider the cumulative impacts of all the pollutants, past and present, affecting the East Phillips community. The cruel bargaining of the city with the East Phillips Neighborhood Institute makes Minneapolis look like a cruel city. Not to mention the many lives this project damages.

Minneapolis has a suitable alternative site on E. Hennepin Avenue. But the city wants to sell that parcel of land to real estate developers, once again prioritizing profit over people.

Steven Smith, Minneapolis

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In the article "Activists ousted from city site" (Feb. 22), city spokesperson Casper Hill is quoted as saying, "There are very small amounts of arsenic in the soils on the Roof Depot site, in line with naturally occurring arsenic levels in Minnesota soil." Yet the Remediation Action Plan referenced in the article clearly states that groundwater contamination at the site is believed to be related to historical agricultural chemical production, specifically arsenic-based pesticide manufacturing. Clearly the arsenic on the site is not naturally occurring and will pose a health risk when released in demolition.

If the city intentionally downplays risks as severe as arsenic, how can this neighborhood, or any neighborhood, trust the city's plans?

Allan Campbell, Minneapolis

I need to commend my carrier, Mario Feria, for an amazing job in getting my paper delivered to me the last two days. Even through a snow storm, Mario had my paper delivered by 5 a.m. He is the most reliable carrier I have ever had, and I thank him.

Sharon Robinson, Chaska