Letter to the Editor
To the editor,
The proposed one billion dollars of federal support for Tennessee’s rural health care comes with some strings attached. These include less regulation on certificates-of-need for new medical facilities and expanding the autonomy of mid-level healthcare providers.
Unfortunately, this is more about the profits of insurance companies and hospital systems than expanding provincial services as borne testament by the heavy lobbying of Tennessee’s libertarian 501(c)s.
Subsidiaries of health insurance companies are aggressively buying doctors’ practices, clinics, and diagnostic centers. They own companies that practice or administer ambulatory surgery, pharmacy benefit management, electronic health records, health saving accounts, and data analytics.
Ostensibly, this is done to better coordinate care and save money, but the “vertical integration” model more often leads to reduced competition, overutilization, and increasing costs.
As hospital systems rapidly consolidate, they offload less-profitable services to these outpatient facilities while retaining equity. Continued expansion has led to monopolization.
For the last two decades, prices for hospital services have been rising unsustainably at three times the rate of inflation.
It’s time we embarked on real health-care reform. Price controls on some medical procedures, disclosure rules for [pharmacy benefits management], updated antitrust laws for “nonprofit” hospitals, and Medicaid expansion in Tennessee would be a good start.
William Culbert, M.D.
Oak Ridge
