Wednesday, March 05, 2008

Is Lifespan Merger Good for Our District?

From the Boston Globe:

You just have to pay it, Steve," Sam Thier, the likable but combative former chief executive of Partners HealthCare, the 800-pound gorilla of the Boston hospital world, used to tell me when I'd ask, as I often did, about the exploding cost of healthcare.
"Of course, you have to pay," says Regina Herzlinger. "The question is how much?"
That is a good question with both Mass. & R.I. (with Lt. Gov. Robert's proposed program beginning to wend its way through the Lege) attempting to answer it. But there is also a more central question that needs to be broached and it is even more difficult to answer. How do we control soaring double-digit costs, most notably in meds & hospital charges which control insurance costs?

Herzlinger lays out her case for another way in her provocative book, "Who Killed Health Care?" which is nothing short of an all-out attack on the "villains" of the current system, including the hospitals, the insurers, and Congress.
What especially caught my eye was her statement regarding the Boston hospital market: "Whenever there is oligopoly in any industry, it is no good. It cannot be good."

In R.I. this could become much worse with Landmark's proposal to merge most area hospitals. While this could work out quite well for them, it's questionable as to the effect on we the consumers. One large company would control most all of our hospital health care system. Forget oligopoly & think monopoly.

The mergers [in Boston], she says, have accomplished their goals: limiting competition and raising prices. Hospitals now hold leverage over the insurers.
Oh, goody. This merger is something that we all should be keeping our eyes on. At some point in time there will be public hearings on it. I don't mind paying for healthcare and I doubt anyone does. The question is how much & when will we just get tapped out by uncontrolled costs? The book's author suggests consumer-driven healthcare reforms is one answer. She wants more data from the hospitals themselves so that one can compare.

A good idea actually, but how much more can I be expected to take ownership of? An example would be the bill for R.I. hospitals to reveal to the Dept. of Health their infection rate AFTER entering the hospital. These infections are the nation's fourth highest killer & are often preventable with better hospital cleanliness outside the operating rooms. Lifespan objected because it was concerned over how the data would be used. I support this bill as it's we the people who basically support hospitals. We have the right to know period. The bill was "held for futher study" which essentially means that it's dead.

Most times I have been to the hospital there really was little choice on my part. Which was closest, which did the procedure and which had the bed doesn't directly speak much to what she's looking for but it's central to me. Frankly competition in this area doesn't seem to work that well compared to which computer do I want to purchase.

America spends $2.1 trillion a year on healthcare, about the size of the Chinese economy. This week the federal government projected that number will double to $4 trillion in a decade. Hospital spending, representing roughly 30 percent of all healthcare spending, was again the fastest-growing sector.
....Another way to think about it is in competitive terms: America spends about
16 percent of its gross domestic product on healthcare; Japan spends about half
that. That difference explains, in part, why Toyota is crushing General Motors.

This is a good argument for universal healthcare with a single payer system. Yes, I don't mind paying but my wallet isn't bottomless. Trusting the hospitals & med companies to monitor themselves with market forces controlling them doesn't seem to be working very well, does it? The Europeans and Canadians have more experience with this & have been quite sucessful. We need to look to them for models & learn from them.

Check out "Who Killed Health Care?" at the library or book store. Editorial reviews of this good. And keep your eyes on that proposed merger. Real-life "Monopoly" is going to take a lot to convince me. And, yes, Newport Hospital is in this District.

ISBN-10: 0071487808

Thanks to Globe columnist Steve Bailey.

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