Opinion: You Can’t be Born in Rochester Anymore

If you’re looking at the potential acquisition of Catholic Medical Center by Hospital Corporation of America and wondering what that future will look like, let me tell you a story. 

I was born at Frisbie Memorial Hospital in Rochester, NH. Just like my siblings and my father before me. Frisbie always operated as a community hospital, serving its patients regardless of their ability to pay and often went above and beyond in their care for the region’s community health needs.

In 2018 when Frisbie was facing financial insecurity, they were slated to be sold to Hospital Corporation of America (HCA). Since this was the sale of a non-profit hospital to a for-profit corporation, the process and sale included review by the Attorney General’s office and a public hearing. Among other things, Frisbie’s board expressed the amount of underinsured care as part of their financial challenges. I showed up at that hearing and asked a simple question of the board and HCA: If underinsured care contributed to the financial straits, how can we be sure the buyer will continue to provide necessary care to this same population? 

I did not receive a compelling answer.

After the sale was confirmed, I was appointed to the Greater Rochester Community Health Foundation. It wasn’t tied to HCA or Frisbie, but instead was created by the proceeds of the sale to provide grants to the community — presumably to pick up some of the community health ‘slack’ that might be lost in this acquisition. While I expected this role would be largely about community engagement and grants, I soon learned that we, by a technicality in the contract, were the only check on HCA’s decision to fulfill or abdicate their obligations under the sale agreement.

Within a year, we learned that HCA had planned to close down the birthing and maternity ward — four years sooner than initially promised in the agreement. They cited a profit motive — birthing wasn’t good business for them, so they wanted to cut their losses. 

As a business owner myself, I can appreciate the need for a company to keep their books balanced for long-term solvency. But I also take seriously the role my business — one that sells coffee, not health—plays in making an impact on the local community. Maternal care — the service that literally creates and supports new families in our region — cannot be about shareholder value. 

So, I led an effort to prevent HCA from closing Frisbie Memorial Hospital’s Birthing Center early, an effort that not only delayed the closure, but also secured millions of dollars of funding to support community and maternal health. But despite these efforts, the reality is, you can’t be born in Rochester anymore.

At the end of the day, I don’t entirely fault HCA — they have their priorities and report to shareholders with profit benchmarks, not our community with health outcomes. All of us here in NH thrive when our communities are healthy. We need to recognize that our entire healthcare and hospital system is in a precarious situation, one that needs strong safeguards and vigilant public servants. 

The acquisition of CMC by HCA would mark their 4th hospital acquisition in our small state. Those in power need to recognize we may wake up one day to find our state’s healthcare system is run entirely by profit-centers who have no duty to provide healthcare for all, nor access to all healthcare services.

What this means for Manchester is residents could lose services it relies on. Catholic Medical Center provides countless services to the community including desperately needed healthcare to the unhoused population and those in recovery. HCA is not a corporation interested in taking care of the most vulnerable, their focus is their shareholders and gaining a larger share of healthcare in our state so their stranglehold on healthcare leaves many of us with few other options. 

Our community and Attorney General learned a lot from the latest sale of Frisbie. I urge residents and public servants to proceed with extreme caution and apply due scrutiny. Does the purchase agreement have adequate safeguards in place for essential health services — not just limited to maternity care but also primary care, emergency/ambulatory response, and others? Is HCA willing to fully take on the financial risks associated with the purchase — liabilities that can be offset by their massive capital account — or will they put the burden back on the community through clawbacks and escrow accounts as we saw with the sale of Frisbie? Will HCA make a longstanding commitment to the underinsured and community health, or will they place that burden solely on a fledgling foundation like the Greater Rochester Community Health Foundation? And should HCA renege on any promises in the sale, who has the power to hold them accountable?

Out of state profit motives are corrupting our ability to provide adequate care for all — HCA is just one piece in the puzzle. But with no statewide plan to address the healthcare crisis — from closing clinics to a reduced healthcare workforce to rising medical costs to those who cannot afford insurance—we are sitting ducks if we allow large corporations to exploit this fragile situation. This is a moment to safeguard healthcare access for today and our next generation.