Rural patients in southeast Minnesota hurt by inclusion in Mayo Clinic network

Don't miss this story by Dan Diamond for Politico.   The headline is "Tax-exempt Mayo Clinic Grows, but Rural Patients Pay a Price."  The subhead is equally provocative:

The famed medical center builds a grand main campus while consolidating services elsewhere.

Here's a short excerpt:

Patients from nearly 150 countries travel to Mayo Clinic sites in Minnesota, Arizona, Florida and beyond. Famed filmmaker Ken Burns is making a documentary about Mayo and the story of its founders — Will and Charlie Mayo, a pair of brothers and doctors who have assumed near-mythic status in the health care field. It's the system that lawmakers around the nation cite when pushing health reforms, and that clinical researchers praise as a model for other caregivers.

But in Albert Lea, Minnesota, a small city set among cornfields and lakes about 64 miles from Rochester, Mayo Clinic is something else: the enemy. 

Mayo took over the hospital that serves the 18,000-person city in 1996, and residents have seen services and supports slowly bleed away ever since. In 2012, Mayo merged Albert Lea’s hospital with another Mayo-owned facility 23 miles away, and locals say their control of the hospital's fate went with it.

The story quotes Paul Overgaard, an octogenarian and former state law maker who is a long-time resident of Albert Lea:

The noose tightened imperceptibly at first.  Mayo made all these overtures about, oh, it's going to be so good. I wouldn't say we were stupid, but we believed people when they told us.

Turns out, Mayo has expanded its campus and its reputation at the cost of places like Albert Lea, whose residents now have to travel farther to have babies delivered and for intensive care.

The service area for Albert Lea's hospital includes more than 50,000 people, and the description of Albert Lea makes it sound like a thriving place as small metropolitan areas go.  If things go as Mayo is planning, Albert Lea may soon be "the biggest community in the state and one of the largest in the nation to not have a full-service hospital."  Still, in the hospital biz as in so many others, bigger is seen as better, efficiency--and, economies of scale, it would seem--above all else.

Minnesota Attorney General Lori Swanson and Lt. Gov. Tina Smith have asked Mayo to pause its consolidation to allow time for more review.