Submitted by Der_Missionar t3_z6875t in Pennsylvania
Growth in hospitals, expansion, building sprees, consolidation of medical services, etc, how it affects pricing, and paths to address the situation.
First part of a three part series.
Their nonprofit status might not seem great, but research the alternative of corporate lead private equity backed healthcare companies.
Not a great alternative which is playing out across the country right now not exactly to the benefit of patients.
Um, no. For profit healthcare is the devil.
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>The expansion of large medical systems into suburban areas steers patients into these larger systems, eliminating competition with smaller health care organizations. Without that competition, costs will increase, critics maintain.
Its a complex situation but the reality is that healthcare centralization has been underway for almost two decades now.
The smaller suburban systems have been going bankrupt for years. The rural systems have almost completely ceased to exist.
Many of them have been bought up by private for profit systems, which is really just the acceleration of the death spiral for a health system before its closed and sold off.
The expansion of large medical systems with outpatient services that funnel patients into thier central hospitals for advanced procedures, is really the only way that many suburbs are going have health systems at all in the future, as smaller ones continue to be unable to cover costs.
The idea that a free market exists in health care, and that price competition between hospitals is even a thing, is a conservative fever dream. It's never existed in practice.
My friend is a doctor, and had his own practice, the problem he faced was that UPMC insurance wouldn't cover his practice, and essentially forced him into joining UPMC.
He was going under BECAUSE UPMC insurance wouldn't cover his practice. After it was clear he had no way of staying in business UPMC "graciously" offered to buy him out.
Several friends in this situation.
Fuck UPMC.
There is one additional complexity. PA has not passed tort reform for medical malpractice. As a result, awards are basically unlimited and up to jury discretion.
That makes malpractice insurance for private practices VERY expensive. Large conglomerates like UPMC and AHN pool the risk and may even self insure to some degree.
Local doctors just can’t afford it. I have a buddy that was a urologist. He was paying over 750K a year for malpractice insurance in PA for a 5 doctor private practice group almost 10 years ago. He moved to a midwestern state that had reasonable tort reform in place and paid $400K for a 7 doctor private practice in the same field.
Those malpractice insurance costs are driving a lot of doctors to sell.
Why would UPMC insurance cover practices they don't own?
It's a smart business move by them to consolidate the market to themselves if they want to be around and offering advanced procedures in another decade.
This is the inevitable outcome of having health policy that pretends that a free market can exist in the health care industry.
It's actually VERY NEW to have an insurance company OWN the hospitals and the doctors offices. Up until a few years ago, this never happened.
Insurance was insurance, hospitals and doctors were hospitals and doctors. Now it's all intermingled. So... That's an ongoing discussion in the government. Don't you remember the BIG TODO with UPMC refusing to cover anything in Allegheny Health Network?
This is the stuff of anti-trust lawsuits going on right now.
So, yeah, insurance never owned the doctors offices and hospitals before.
Also, with abortion basically criminalized in WV and OH now, PA will see an influx of patients. Not just for abortion services but many obstetricians and obgyns are retiring early or leaving those states making it harder to get appointments. There will be a spill over into western PA for sure
Gee I'm so glad we as a society have decided that healthcare should be a for profit institution!!!
I’m all for single payer
Medicaid for All is what you're after. Unfortunately, many doctors and hospitals do not accept it. But you'd have single payer.
Everyone supports single payer except for Brian, 33, the designated single payer.
“I’m just saying maybe we should consider some other options!” - Brian
Why are they building new hospitals when they don't properly staff the ones they have?
Health care is a human right. Fuck a system that values profits more than human life. Tear it all the fuck down
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They keep building more outpatient clinics and shit on the east too. Every time I see construction I assume it’s a overpriced “luxury” apartment complex or a clinic I can’t afford because I can’t afford insurance
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Huldati t1_ixzximi wrote
I recommend the healthcare systems lose their nonprofit status. Or they actually start acting like nonprofits and PA holds their feet to the fire.
But don't mind me, I'll just continue to drink my tea.