Earlier this month, President Biden issued the “Executive Order to Promote Competition in the United States Economy,” calling on the Department of Justice and the FTC to review and modify the merger guidelines to ensure that participants in the health care is still forced to compete for the best interests.
The health integration review needs to be strengthened, but frankly it is too late.

Hospital integration is not new. Bringing Value to Healthcare reviewed how hospitals “started large-scale joint ventures and frenzied purchases” in the 1990s, they said, to increase productivity and profitability. Few acquisitions have met their supplier sourcing expectations, and while many can promise that unions will reduce health care costs for consumers, the result is quite the opposite.

In the 2010-2013 analysis of the 25 metropolitan areas with the highest rate of horizontal integration (that is, integration between two hospitals or health systems), the average cost of hospitalization of private insurance in most areas increased by 11% and 54%. Follow, continue.
To some extent, the damage has already been done. Unlike other industries, consumers can know in advance where they spend their money. In the field of health, consumers are used to being kept in the dark when evaluating the health services they consume. Fundamental disregard for transparency is the norm, as is a system that is primarily paternalistic and opaque.

Only recently, and because costs have gotten out of control, have consumers started asking for a change. They used to be reluctant to comment on this topic, because “others”, that is, their insurance companies, paid the fees, but today, consumers are not afraid to send their “surprise” medical bills to reporters: expensive or off the grid. expenses come from online hospitals. If it comes from anyone other than health care providers (car dealers, TV repairers, Internet providers, landscaping companies, etc.), as long as they tolerate these unexpected bills in the health care industry, consumers they will never accept them.

This means that the integration of the last decades has caused harm to consumers. Today’s high consumer cost and lagging quality issues cannot be resolved by individual review of future mergers or by lengthy court battles to dissolve approved mergers. There are other more significant ways to improve care by realizing market-based competition on two things: the cost of health care and the quality of health care.

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The Trump administration began to advance the first through hospital price transparency rules that went into effect in early 2022. President Biden wisely said he will support the rule, but there is more that can be done here. A starting point will be stricter enforcement than we’ve seen so far in this administration. Earlier this year, a systematic survey revealed that 65 of the 100 largest hospitals in the country did not meet transparency rules.

After publishes the data, the next milestone will be to make it easier to understand. Just a few weeks ago, when Bernard J. Wolfson of Kaiser Health News reported on his efforts to list himself, he concluded: 4,444 towels. This is a fool’s errand. Ultimately, my efforts only yielded one helpful suggestion: don’t try this at home.

The Center for Medicare & Medicaid Services (CMS) recently announced that it will increase penalties for systems that do not comply with the hospital’s price transparency rules; this is a step in the right direction in terms of transparency. However, it really must touch consumption. The main concern of the consumer, there should also be rules of transparency of hospital results. Once consumers understand the cost of certain health care services, the next logical step is to enable them to understand the level of return they are achieving.

What needs What must be clear is that these results not only depend on the performance of the hospital, the health of patients outside the health system is equally important. If consumers in a particular area cannot obtain shelter, transportation and/or healthy food, this will have an impact on the outcome data of the local healthcare provider. One point for prevention is better than one point for treatment. We must better address the social determinants of health and make it easier for consumers to obtain initial support.

Lack of access to behavioral health services can also have an impact. If left untreated, anxiety, depression, and other behavioral health problems may get out of control. When this happens, disturbed sleep patterns and disordered eating habits can quickly deteriorate physical health.
Allowing consumers to receive more physical and behavioral health supports, not just the fundamentally flawed health care system itself, will be a step forward for this country, assuming consumers use these services. As we are seeing now with the Covid19 vaccine, if the scientific benefits of such interventions are not clearly understood, then consumers may neglect to take action, which will affect the health of the population.

Opposing healthcare integration is not the only way to increase healthcare competence, nor is it the most effective way. If the goal is to improve care, the competition must outperform cost and quality; we all have to play our part. If the hospital and healthcare system choose not to cooperate, noncompetitors will continue to cannibalize their lost business.

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