Became Big Business and How You Can Take It Back by Elizabeth Rosenberg MD Dennis Slater, MD
The American healthcare system is in disarray and
failing. 20% of the gross national product is spent on “…in 2009 Sutter Health ended its role of supporting medical care and our health statistics are at the bottom locally owned hospitals and embarked on a state wide of the wealthy industrialized countries. This rant is now merger strategy called regionalization.” cliché, tossed at healthcare professionals from every angle – industry, politicians, patient advocacy groups. “In 2011, a Sutter Health representative rewrote the Out of this cacophony comes a treatise by Elizabeth hospital bylaws with more than a thousand changes… Rosenberg, an internist. Her voice is clear and familiar. Sutter drew up a plan to replace Coastal Hospital’s She thinks and writes like a doctor who has been in the board, then made up partially of locals, with a trenches, carefully documenting through a series of committee that had no decision making authority personal encounters shared by all of us, the dysfunction under regionalization.” and decay of our medical system. “Regionalization is okay if it brings operational So what is new? Nothing really, except that Dr. e ciencies, ut an e ecutive even t l us t ere are n Rosenberg dramatically shows that competitive e ciencies in t is mer er t s a ut c ntr l, pricin , market forces, designed to lower costs in a free market, c ntracts, pr fits paradoxically and shockingly heightened costs at every level – hospital bills, doctor bills, insurance “In December 2013 Sutter announced that Coastal premiums, drug costs, laboratory and radiology costs. spital as n t financiall via le an ul e And we doctors, willingly or not, are drawn into the converted into a critical care hospital – downsizing vortex of spiraling costs. The distortion of the market from 49 to 25 beds.” inescapably argues for external (governmental) controls. Needless to say, a familiar ring and chillingly prophetic. The chapter on “The Age of Conglomerates” is particularly relevant to physicians at Backus Hospital. Dr. Rosenberg’s prescription for curing the sick Dr. Rosenberg targets Sutter Health, a corporate giant healthcare system is fuzzy, but her sense of direction is in Cali rnia, ic u s financiall tr u le spitals, spot on – patients (inevitably all of us) must know the monopolizing healthcare access geographically, thereby cost of care and be educated and empowered to select increasing charges. No surprise. This scheme works for quality care at lower cost. But who among us knows a while until Sutter Health is shunned by insurances. our own cost? g But it is the story of Coastal Hospital, a small community owned hospital which joins Sutter Health, which is personally poignant.