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Portland-area hospital operators who have expressed concerns over Kaiser Permanente's proposal to build a new hospital in Hillsboro ought to be careful, or they might get what they least want: increased regulation of their own operations and ability to grow.

Kaiser has proposed building a 138-bed hospital in western Washington County after losing out a few years ago on the prospect of expanding in Beaverton.

However, Providence Health System of Oregon (the operator of Beaverton's St. Vincent Medical Center) and Legacy Health Systems (the operator of Tualatin-based Legacy Meridian Park Hospital) have asked the state to deny Kaiser's westward expansion. The state operates a Certificate of Need Program that reviews and approves the construction of new hospitals based upon whether a new hospital is needed and would not negatively impact existing hospitals.

Providence and Legacy want the state to put Kaiser to an additional test. They say, before approving the new hospital, the state should also consider whether Kaiser sufficiently serves Washington County residents who are indigent or uninsured. Providence and Legacy do provide significant charity care. Kaiser Permanente, which is part of a closed system that largely serves those covered by its own insurance system, probably serves fewer needy patients.

What is troubling about Legacy and Providence's objections is that both hospital systems continue to rapidly expand on the Westside. Providence recently opened a new hospital in Newberg. A few years ago, Providence unsuccessfully sought to build a new facility in Hillsboro, but was blocked by significant opposition from community and city leaders who sought to protect Hillsboro's own Tuality Healthcare Hospital from more competition. Meanwhile, Legacy continues to add on to its Meridian Park facilities.

So the suburbs obviously have expanding healthcare needs and consumer demand. So why should Kaiser not be allowed to expand in Hillsboro?

There is probably much more to Providence and Legacy's objections than just balancing health care for the needy. Politics? Economics? A desire to retain market share?

Whatever the reasons, both hospital organizations need to be very clear in detailing their concerns about Kaiser's plans for risk of alienating the public who primarily want access to good medical care at a fair price.

Legacy and Providence also should not provide more impetus to a proposal to have Metro get involved in determining whether hospital expansion plans meet community needs. The push to have the regional government assume this role is largely coming from union groups that support greater regulation of hospitals and also a larger union presence among hospital employee groups.

We have said before we want Metro to stay far way from healthcare matters and instead focus its attention on growth management, solid waste management, transportation planning, open space protection and operating the Oregon Convention Center and Oregon Zoo.

But we would support the state of Oregon better defining its rules of consideration for new hospitals and by expanding its approval to include major hospital additions and service expansions.

Meanwhile, hospital operators, such as Legacy, Providence, Kaiser and Tuality need to explore and initiate partnerships that better serve the health care needs of the community and its residents.

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