June 30, 2012

Hospitals Now Are More Monopolistic

Medical practice is nearing a crossroad and not the road everyone is talking about. This is the legal mess of monopolistic medicine that many patients are starting to wonder if this is in their best interest. While it is true that we will continue to need hospitals, the size and dictatorial power they will possess may not be in the best interest of medicine. A hospital monopoly combined with the insatiable appetite for profits may create problems in patient care with too many patients being ignored and euthanized to preserve the almighty profit.

Hospital CEOs will demand higher and higher salaries and bonuses and as such, it will become second nature to end life for patients needing care that is more expensive. This drain of financial expenditures will be unacceptable for these hospitals and we know what this will mean for the patient. If you want an example, read this article of what is being allowed in Britain. Follow the link provided for the chilling details. Don't wonder how or if this will happen in the USA, but be concerned about when.

Under the Patient Protection and Affordable Care Act (ACA), the rising cost of medical care will become a priority and euthanasia will become a fact of everyday cost cutting.  When the ACA was first enacted, it was thought that physicians and hospital accountable care organizations (ACOs) would be approximately proportionate. I don't think the early prognosticators had counted on hospitals having almost the entire lock on ACOs. It is now speculated (unfortunately no official studies) that doctors were not creative enough and lacked leadership skills to organize ACOs. Hospitals were willing to seize the opportunity and take advantage of doctor indecision to hire a majority of doctors. Hospitals thereby garnered most doctors leaving too few capable of forming ACOs.

Up until June 28, 2012, there was more speculation than fact about what would happen to ACOs, but now we know which way the arrow is pointing. I suspect there will be many lawsuits trying to break the monopolies that hospitals will be creating. We have seen hospitals also merging and becoming larger and larger. Size and scale will create some savings, but not enough to make up for the increase in expenses and inefficiencies generated by bloated overhead and massive referrals internally.

In addition to the mandate to cut expenses (creating more euthanasia), we will soon see the medical insurance industry supporting euthanasia as a method of keeping their profits on the rise. These two profit minded organizations will be able to eliminate many costs but supporting each other and still have the financial ability to fight the lawsuits bound to happen for unwarranted euthanasia.

A study that is going to create some controversy around the country is this one. I am seeing some of this in my own community and surrounding communities and if people could read about this study, many might not be so happy. Yes, there is some need in Iowa's rural communities for better medical care, but are we really obtaining it. In many cases, much of this may go unnoticed because to the protection that is being given ACOs from antitrust and other benefits. The current administration is promoting the formation of ACOs and shielding them from antitrust laws.

The further I get into some of the new law and the discussions, blogs, and articles that I read, the more I have some real concerns about the impending abuse and fraud that will accompany the Accountable Care Organizations. I am now even more concerned because of the Supreme Courts action.

Because of all the concern being raised, we will have of course more abuse and fraud as the different departments, the Department of Human and Health Services, the Federal Trade Commission, and the Department of Justice, under the direction of the White House, have been and will be granting more waivers, safety zones, and guidance to providers.

It is unclear if the law, the Affordable Care Act provides for waivers and the legality of these waivers. An ACO, as defined by ACA, is an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare patients for whom they provide the bulk of primary care services. With hospitals having all but eliminated private medical practice in some areas of the country, they will continue their efforts in the rest of the country.

Although I have seen no discussions yet on the independence of the different medical associations, if a majority of doctors are hospital employees, does it not seem reasonable that the hospitals will soon be making their agenda felt in the medical associations. I think we have seen this in the quick response of the American Diabetes Association to the Supreme Court decision.

I have pulled many different areas together for this blog. I am working on more now that the Supreme Court has ended the ambiguity.

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