My Letter to the Editor in April 28 Wall Street Journal

Today, April 28, the WSJ published a letter of mine among 4 letters under the umbrella title of “The Government Is Big on Antitrust, Except in Medicine."

My letter read: “Because of ObamaCare’s onerous regulations, reimbursement cuts and expenses and time spent on electronic health records and ICD-10 coding, physicians are being propelled into hospital employment. Hospitals, in turn, to protect themselves against ObamaCare penalties, are consolidating into dominant entities. These entities are often the only game in town."

"When you are a monopoly, you tend to charge what the traffic will bear. Hospital executives arene’t evil. They are simply reacting to save their skins and grow their businesses. I favor freeing up the regulations on physicians so they can compete with hospitals."

The other 3 letters were from,

Brian Kent, MD, of Tulsa, Okla said, “As large hospitals digest other hospitals and physician practices, I don’t see anything positive for patients an doctors."

Robert Geist, MD, of St. Paul, Minn. commented, “ The question is: Ehich cartel partners will control the other” The price to the nation of a state-corporate cartel system has not been calculated; it may be very high.”

Rich Umdenstock, President and CEO, American Hospital Association, noted, “ We all want hospitals to continue the good work of coordinating care , and integration across facilities is a particularly good way for hospitals to organize themselves to do so. Coordination requires the kind of teamwork that often works best when everyone is under the same ownership umbrella.”

As I observed in a recent blog, hospitals tend to be King of the Health Care Mountain with physicians as their serfs in any given community. Most often hospitals are Kings because of their organizational structure, access to capital, time that can be devoted to organizational matters, their political clout as the largest employer in town and the their central role as a health care center.

There is nothing wrong with this. It is the role of the hospital executive to make profits and to advance of their institution and their careers. Unfortunately, the result may be higher health costs because of higher overhead costs in acquiring and maintaining medical practices, less productivity of employed physicians, the ability of the hospital to charge high hospital “facilities fees” and to negotiate higher fees from 3rd parties as the only game in town. Having hospitals, physicians, and sometimes health plans under one corporate roof has advantages in marketing, pricing, and market dominance.






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