Despite the Supreme Court’s recent decision upholding the Affordable Care Act (ACA), few Americans are paying attention to the bigger picture—progressive consolidation of control over the healthcare system by the hospital and insurance industries.
This trend will destroy the valued relationship of patients with personal physicians. Our healthcare system, demonstrably once the best in the world for the majority, is being replaced by a more expensive and arguably worse system. Our citizens want affordable health insurance, but they also want choice.
Hospitals increasingly are merging into “nonprofit” multihospital systems or consortia, imposing significant financial pressures on their salaried physicians to retain patients, even if superior care exists elsewhere.
A decade ago, hospitals were mainly for inpatient care, and outpatient care was the domain of private doctors. Now, the greatest profit center of hospital consortia is outpatient care. Government policies not only permit profitable billing practices favoring only hospitals, they also help facilitate hospital mergers. Both of these factors contribute to unsustainable health cost inflation.
Mergers in the hospital sector increase hospital leverage in negotiating with insurers, driving up reimbursement and ultimately premiums. At the same time, they demonstrably result in a decline in service and quality of care.
