Healthcare consolidation has fol­lowed the air­line model

Modern Healthcare - - COMMENT -

Re­gard­ing the ar­ti­cle “Mo­nop­o­lized healthcare mar­ket re­duces qual­ity, in­creases costs” (Mod­ern­Health­, April 13), this hy­poth­e­sis is clear and cor­rect, no dif­fer­ent than what con­sumers have faced with the consolidation of the air­line in­dus­try—higher prices, un­bundling of costs for in­cre­men­tal rev­enue, and less choice, cre­at­ing a down­ward spi­ral of dis­sat­is­fac­tion.

Not only have we never achieved real cost sav­ings nor im­proved qual­ity from hos­pi­tal com­bi­na­tions, costs have ac­tu­ally in­creased as com­pet­i­tive mar­kets shut down. As hospi­tals played Pac-Man with com­mu­nity physi­cian prac­tices, how much did costs in­crease due to the hospi­tals’ outpatient and an­cil­lary charges by in­clud­ing all that ex­ces­sive hos­pi­tal over­head? Just look at the cost in­creases af­ter com­mu­nity on­col­ogy prac­tices were brought back in­side the hos­pi­tal, negat­ing their op­er­a­tional and ex­pense ef­fi­cien­cies.

Also, how many health sys­tems have vi­o­lated the in­tent of the 340B drug pro­gram to max­i­mize rev­enue by avoid­ing true cost con­tain­ment and op­er­a­tional ef­fi­cien­cies? The board of di­rec­tors and/ or own­er­ship should be held legally cul­pa­ble for tol­er­at­ing such non-com­pli­ance, as well as for the myths of con­sumer eco­nomic ben­e­fits.

M.E. Singer Chicago

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