Will Texas AG Ken Paxton Acknowledge the Heartfelt Pleas from San Angelo's Citizens?


SAN ANGELO, TX — Irving attorney Paul Craig Laird may have uncovered a groundswell of opposition to the Shannon Health acquisition of San Angelo Community Medical Center that is expected to be rubber stamped by the Texas Attorney General Ken Paxton as early as Friday, Oct. 2.

Laird said in a letter to AG Paxton on Tuesday, Sept. 29, that he collected 165 signatures — 130 of those electronically — to request a hearing with the AG about the proposed monopoly hospital in San Angelo that will be the result of Shannon’s asset purchase of SACMC from Community Health Systems.

Shannon is benefitting from a new law in the Texas Statutes that provides protection from anti-trust litigation if it acquires its competitor and becomes the monopoly hospital in the region. Hendrick Health System in Abilene has applied for the same protection to buy CHS’s Abilene and Brownwood hospitals, making Hendrick a monopoly hospital in Taylor County. State law requires each purchaser to acquire a Certificate of Public Advantage, or COPA, from the AG and Texas Health and Human Services Commission. The COPA provides the monopoly hospital anti-trust protection by also promising State oversight.

Shannon’s COPA is due to be approved or disapproved by the AG and HHSC by Oct. 2, according to filings.

Laird explained in his letter that, “Pursuant to the Texas Health and Safety Code Chapter 314A § 201 the Attorney General has authority for a hearing on the determination of the Certificate of Public Authority.”

And, Laird continued, “Pursuant to Texas Government Code § 2001.029 if at least 25 persons request a hearing then the agency, in this case the Attorney General’s Office, shall grant the hearing.”

The online petition, that required petitioners to digitally sign and provide their physical address and email address, also allowed for comments. Laird provided LIVE! a copy of his letter and petition that was addressed to the AG and HHSC Chief Deputy Commissioner Cecile Erwin Young. The petition’s comments were illuminating and may represent a groundswell of opposition within our community to the resulting Shannon monopoly.

The Federal Trade Commission estimated that should the acquisition happen, Shannon Health will employ over 96 percent of all nurses in San Angelo. One petitioner explained what the result of this might be.

“[H]ow can San Angelo residents/employees receive competitive salaries for their service? When they would be forced to except Shannon’s wages and benefits or work out side San Angelo (their beloved home town) for a more competitive wage and benefits. Not to mention the better candidates will likely choose to work outside San Angelo because of the better wage and benefit packages,” the petitioner wrote.

Other remarks bemoaned the monopoly and took aim at the petitioners’ lack of confidence in Shannon that it will be a benevolent overseer of a healthcare monopoly here.

“The sale of CHS in San Angelo will finalize Shannon's Cartel practice of medicine,” one petitioner wrote.

“I do not believe a monopoly in healthcare is good for San Angelo,” another wrote.

“Great concerns regarding limited competition resulting in unfair pricing, poor quality of care, and restriction of patients rights to achieve their needs without having to leave town, if they do not want to use Shannon. All communities of this size need a choice in healthcare services. All medical providers who live here should be able to choose who they want to work for, not have to leave if they do not subscribe to the Shannon philosophy. Independent medical providers could be denied hospital privileges should they not want to do exactly as Shannon dictates,” another petitioner wrote.

More petitioners predicted doom for healthcare workers’ opportunities.

“San Angelo’s economy is braced by employment of medical staff residing in the Concho Valley. Without employment options, we could see an exodus of medical staff from our area,” a petitioner predicted.

Another was more direct. “No to the monopoly, no to increased health care costs, no to crappy wages with no competition,” a petitioner wrote.

“What about the healthcare workers? If I were to lose my position I would have to sell my home and relocate. The same applies to my wife. Shannon would have total control of healthcare workers,” another healthcare provider wrote.

“San Angelo needs two hospitals to keep everyone honest,” wrote another petitioner.

On insurance, some noted Shannon does not currently accept Obamacare health insurance plans. “Shannon does not accept insurance purchased through the health insurance market place. Shannon says it won’t change but me knowing Shannon they will without notice,” a petitioner wrote.

Shannon has promised to accept the Affordable Care Act HMO policies after the acquisition.

“I feel that this merger will be detrimental to the compassionate culture of SACMC. Further, quality employees leaving our community is a real possibility as the benefits paid (insurance specifically) will have a negative impact on them financially. Plans have already been rumored that the Heart Program and Women’s and Children’s Services will move to the main campus eliminating the need for some personnel. Ultimately, this merger will take away CHOICE for patients and employees,” another petitioner wrote.

An employee from a hospital in a smaller community in Shannon Health’s service area claimed it will harm her facility. “I believe the proposed merger will damage hospitals and health care facilities that are not affiliated with Shannon. We, in our small town, need our hospital. We want to remain independent of the corporate greed that is evident in this proposed merger,” the employee stated.

Laird said all he is requesting is a public hearing in front of the State decision makers who will grant Shannon the COPA.

“There seems to be too many questions at this point,” he said.

Laird said the same letter was copied to the Federal Trade Commission. The FTC previously submitted a 70-page letter of their own to AG Paxton and Commissioner Young on Sept. 11 requesting the COPA be denied.

Laird collected signatures and comments from 165 citizens opposed to the merger — or at least wanting a public hearing. On the other hand, a list of “who’s who” of San Angelo’s political, business, and non-profit organizations submitted letters of support. Their names are here.

The general feeling of those opposing the acquisition was expressed by this petitioner, who stated, “There are numerous nurses, doctors, and other medical professionals who cannot work for Shannon, for whatever reason. To allow this merger would force them out of their careers. It would also definitely kill any private practices left in the area.”

“Please allow for public comment on this process,” he concluded.

Laird said he continues to collect signatures on his petition. You can view the petition form here.



The purchase of Community by Shannon is inevitable. Unless some other large, regional player, like Scott & White, has put in an offer, Shannon will own it, inexorably. Management at Community has decided it is their best interest to sell for a reason. They are either signaling SOS or saying, “If you can’t beat’em, join’em.” Either Shannon buys it and a few grievances are suffered, or Community folds, and the whole town suffers as an acute crisis unfolds: the loss of all the jobs there—not just a few, the loss of all the services they provide, and the waves of repercussions thereof. Then, Shannon buys the corps of what used to be Community and has to start from scratch to restaff and reequip it to provide services again. Objective, deductive reasoning and what I’ve learned studying economics and economic game theory have lead me to this forecast.

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