This piece outlines what's at stake in the WSU-DMC negotiations. The two parties have an $80 million contract - most of which is from Medicare - that expires Dec. 31. About half the money pays WSU doctors to care for DMC patients, the majority of whom are uninsured or underinsured. The rest pays WSU to oversee medical residents who work at DMC hospitals. The cash-strapped DMC has been eyeing part or all of WSU's share of the contract in hopes of adding the revenue to its bottom line. Also a point of contention is a planned new medical facility in Troy, being built in conjunction with Oakwood Health System, where physicians from the Medical School would practice. The DMC says the facility will compete with its services. WSU officials say they tried to build a similar facility in Detroit but the DMC rejected it. If there is no agreement, the DMC would have to consider whether it wants to remain a regional health system with nearly 20 specialty services or downsize to focus on more profitable programs, such as cardiology.