A proposed $1 billion in federal support for rural health care in Tennessee comes with some strings attached. These include reducing regulations on Certificates of Need (CON) for new medical facilities and expanding the autonomy of mid-level healthcare providers.
Unfortunately, this is more about profits for insurance companies and hospital systems than expanding provincial services, as evidenced by the heavy lobbying by Tennessee’s liberal 501(c)s.
Affiliates of health insurance companies are actively acquiring doctors’ offices, clinics and diagnostic centers. They own companies that perform or manage outpatient surgeries, pharmacy benefit managers (PBMs), electronic health records, health savings accounts and data analytics.
Ostensibly, this is done to better coordinate care and save money, but the “vertical integration” model more often results in reduced competition, overutilization, and increased costs.
As hospital systems consolidate rapidly, they transfer less profitable services to these outpatient facilities while retaining equity. Continued expansion led to monopoly.
Over the past two decades, the price of hospital services has been rising unsustainably at three times the rate of inflation.
It’s time for us to start real health care reform. Price controls on certain medical procedures, disclosure rules for PBMs, updated antitrust laws for “not-for-profit” hospitals, and Medicaid expansion in Tennessee would be a good start.
William Culbert, Oak Ridge, 37830
This article originally appeared in the Knoxville News Sentinel: Letter: Tennessee Rural Health Grants Aimed at Profits, Not Patients
