The roles of national hospitals and national sanatoriums in Japan.
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As the result of a study, in 1982 St. Benedict's Hospital, Ogden, UT, reorganized as St. Benedict's Health System. The results of the reorganization were disappointing, however. Within three years, major financial difficulties, the lack of success in diversification on programs and facilities, continuing environmental pressures, and unrest within the organization led St. Benedict's to seek assistance. After contacting a number of Catholic systems, St. Benedict's chose the Holy Cross Health System, South Bend, IN, as the preferred partner. In mid-June 1986 the two systems began negotiations on a possible affiliation. Holy Cross sent an acquisition team to St. Benedict's to obtain a perspective on mission continuity, profitability, market share, and operations. Discussions continued through July, with neither system proposing an affiliation agreement. St. Benedict's was still considering other options, while Holy Cross was concerned about the financial ramifications. On Aug. 20, 1986, the two negotiating teams met face to face for the first time, with a Catholic Health Association representative acting as facilitator. The two teams met again on September 8, and St. Benedict's accepted Holy Cross's terms. While awaiting antitrust review of the affiliation, Holy Cross operated St. Benedict's under a management contract. The consolidation was formally completed on Dec. 1, 1986. Holy Cross took over ownership of St. Benedict's Health System, cosponsored by the Sister of the Holy Cross and the Sisters of the Order of St. Benedict. Holy Cross established tactical objectives aimed at stabilizing and enhancing St. Benedict's Hospital. The new owners and managers report they have achieved the objective which has improved St. Benedict's operations.
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Hospitals came into the twentieth century as creations of local, usually altruistic, interests and wrestled with accelerating change throughout the decades. Their success brought third-party financing, employee health plans, and government guarantees for charity care. Success seemed to breed success, and they raced ahead with capital investment in bricks, mortar, and high technology, only to find themselves in increasing trouble as 1990 approached. Writing from the precarious perch of the year 2000, the author views the worsening hospital situation and raises questions about the contradictions of federal interventions, the efforts to create "systems," the plight of small hospitals, and the love-hate role of medical staffs. Offered for consideration is a scenario of a health care crisis in the early 1990s comparable to the savings and loan crisis of 1988. However, this time the federal intervention is not simply in dollars, but, instead, brings on a "health for all" program with national financing and decentralized "district health" management. As in other nations of the world, hospitals become an integral part of the commitment to attack the root causes of ill health.