Close smaller hospi­tals? Con­sider the con­se­quences

Modern Healthcare - - COMMENT -

Re­gard­ing the ar­ti­cle “In­vest in new hospi­tals? Re­ally?” (Mod­ern­Health­, Sept. 27), it would help to leave Trump out of this dis­cus­sion— and any other. Some ar­eas do have more hos­pi­tal ca­pac­ity than needed to­day. How should that ex­tra ca­pac­ity be ad­dressed? Clos­ing a smaller hos­pi­tal in a city can force pa­tients into sur- viv­ing large teach­ing hospi­tals, boost­ing the cost of care. Who ben­e­fits from that? And clos­ings in ru­ral ar­eas can desta­bi­lize eco­nomic growth by un­der­min­ing liv­abil­ity and dis­cour­ag­ing new busi­nesses. In both in­stances, los­ing the hos­pi­tal can desta­bi­lize sur­viv­ing physi­cian prac­tices. Pa­tient ac­cess can suf­fer. Be­sides, empty beds add tiny costs since they aren’t staffed, and might be needed in the fu­ture. With­out ei­ther a func­tion­ing com­pet­i­tive mar­ket or com­pe­tent govern­ment ac­tion, we’re de­scend­ing into health­care an­ar­chy.

Alan Sager Pro­fes­sor of health law, pol­icy and man­age­ment, Bos­ton Univer­sity School of Public Health

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