Officials at Sanford Health, based in South Dakota,  are having discussions with officials at Fairview Health Services, based in Minnesota, about a merger. Each organization has about the same number of employees and revenue. Fairview has been without a CEO for almost a year. Sanford has Kelby Krabbenhoft.

The Attorney General in Minnesota, Lori Swanson, appears negative to the possibility of Fairview merging, or being taken over, by an out of state entity.  A hearing held Sunday in the Twin Cities, sounded more like a witch hunt than an information gathering event. Fairview has a long history in Minnesota, with deep ties to the University of Minnesota Medical School and community.The next public hearing on the subject will be April 21.

Two Democratic Minnesota Legislators have introduced a bill to prevent any out of state  organization from taking control of the U of Minnesota Hospitals. No hearings scheduled yet.

There are many interested parties in this discussion. The boards of both organizations, and their employees are obvious. Also, people affiliated with the University Hospitals currently involved with Fairview. Doctors, nurses, students, researchers, and of course patients, have an stake in what and how things happen. The involvement of Minnesota's Attorney General, and now at least two Democratic Legislators adds an interesting political element. And, of course, lawsuits filed by the state, and other parties, can make for a quagmire.

Sanford has been aggressive in acquiring facilities, territory, and employees. The recent merger of the health system in North Dakota, makes Sanford one of the largest geographic medical entities in the country.   Sanford is also setting up facilities not just in other parts of this country, but in selected places in the world.

Clearly some people in Minnesota are not happy with Fairview board and staff members who are talking with Sanford representatives.

This will be an intriguing process. If this merger happens it will be a long slog to the end. The hearing on April 21st in the Twin Cities should be fascinating.

As an observer, I wonder,  with a merger, will patient care and outcomes improve? Will costs to all  patients stabilize or even go down? Are the discussions about those issues, or about expanding just because they can? Can a healthcare organization become too big to effectively function? Who is responsible for answering that question?