The following is excerpted from “America’s Bitter Pill” by Steven Brill:
“Sometimes, the Federal Trade Commission clamped down when it looked like a hospital merger would too egregiously eliminate competition in a region. But these cases are also uncommon, in part because the hospitals could argue that a merger would cut costs by eliminating needless duplication of services. Why have two cancer care units, or two super-expensive diagnostic labs in the same town?
“Opponents of these mergers pointed out that hospitals rarely consolidated in a way that downsized their activities. On the contrary, the story of hospitals in the United States was much like the story of the other bastion of nonprofit spiraling costs: higher education. No matter how mergers were rationalized, the merged hospital chain seemed to keep building, all in the name of providing broader, more advanced care. That was certainly true – and would continue to be true- of Yale New Haven followings its Bridgeport and Greenwich mergers.
“Moreover, whatever efficiencies those mergers produced by way of consolidation certainly didn’t produce lower prices. Three months prior to the Yale-New Haven merger, there was fresh evidence of that from a highly credible source. ‘Increases in hospital market concentration lead to increases in the price of hospital care,’ reported the Robert Wood Johnson Foundation, a respected healthcare think tank that had just finished an elaborate survey of hospital pricing. The report also stated that ‘at least in some procedures, hospital concentration reduces quality.’
“A subsequent FTC report would find that when it came to consolidation and price increase, the nonprofit hospitals’ behavior was no different than that of the for-profit hospital chains.”
Brill does point out that mergers that are detrimental under the current “pay for services” to individual patients might be beneficial under a future system whereby patients are “bundled” and hospitals are paid a flat rate for population served. This reverses the incentive to run unnecessary testing and procedures and encourages following guidelines, subject to physician discretion, for ‘best practices.’
Obamacare opponents call this process “death juries”, which is nonsense.
Lancaster General Health continues on its historic arrogant, contemptuous path of sharing no information with the public and probably little with its own board. The public and even the medical profession have no idea of LGH’s motivations and plans.
In contrast, Geisinger Heatlh System created a documentary entitled “Retrieving American Healthcare” explaining in detail “The innovation and transformation of Geisinger Health System.” Over two hundred community leaders were invited to a reception, the showing of the video, and discussion led by Glenn D. Steele, Jr., MD, Geisinger president, at Kirby Auditorium in Wilkes-Barre on Monday evening.
LGH seeks to conceal, Geisinger chooses transparency. Geisinger is an example of Lancaster of old.
