Bigger is Not Better

A free public service for a better community

Jul 24, 2023

Happy Monday Healthcare Advocates

I would like to encourage comments and suggestions from you if you have time. If there is a special topic you’d like to see please let me know. Please use the comment button below. Some of the topics in work are funding for key medical research, rural healthcare, and healthcare in prison.

White House Creates Pandemic Preparedness Unit

The Office of Pandemic Preparedness and Response Policy launched on Friday with retired Major General Paul Friedrichs at the helm. The new effort will take over the federal response to covid and mpox and look ahead to future health crises. A positive step as the previous Trump administration disbanded this type of activity shortly after taking office.

Mergers and Acquisitions

This is a complicated subject and thank you to Mo for bringing it to my attention and Jan for asking what we can do. It is a little long and eventually gets to healthcare and something we can do to help.

There has been a lot of consolidation in the healthcare world. Sometimes it might work well. Some states foster mergers because the merged consortium can then negotiate lower prices. Washington State fostered that behavior for 24 rural hospitals that now act as one in the market place. Might be a good thing.

But sometimes when a hospital is purchased, they delete services, like abortion, because the purchaser is a church or church enabled facility. Then patients lose out. This is a big problem where I live and the legislature could not get it fixed this year.

Of course when private equity firms buy hospitals they have a history of bleeding them dry, outsourcing what does not make money, and then pushing them into bankruptcy after they’ve taken as much profit as they can.

Lina Khan is the head of the Federal Trade Commission and she would like to revamp the investigations her organization does to make sure that the consumer is not punished when mergers and acquisitions take place. Here are the regulations she recommends. It is a pdf you download.

(Economics Lesson Here)

Companies have pushed for easier rules with respect to mergers and acquisitions claiming that bigger, better companies would use economy of scale and provide better service at lower price to consumers. It has a nice ring to it. But the evidence is to the contrary. When there are a minimum of providers, they drive up the price, limit innovation, and have a take it or leave it attitude. Hold that thought.

Now healthcare is not an actual consumer marketplace. The patient, nominally the consumer, has limited choice of provider, because insurance plans have networks of preferred providers, and insurance companies limit what services are available that they will cover. So this isn’t Adam Smith’s capitalism. Thus special care is needed when healthcare companies seek to combine and drive out competition.

The new rules would allow the FTC to consider the effect on doctors and nurses as well. Research suggests that wage growth slows following hospital mergers due to shifting labor market power, and that physician income dips when their practices are acquired by hospitals.

Regulators would also be able to examine the effect of cross market acquisitions. Remember that CVS also owns one of the larges pharmacy benefit managers as well as Aetna health insurance.

Anyway the Federal Trade Commission is seeking comments from the public and we have about a month to get them in.

I personally think it is a good idea for the FTC to cast a jaundiced eye toward mergers of medical facilities in the following ways especially with respect to hospitals. I would like them to make sure that there shall be no deletion of medical services when facilities combine and that innovation is not stifled and drug treatments monopolized.

Here is some background reading for you on the subject in your copious spare time.

ACTION

Let the FTC know how you feel. Here is their website for comments. We have until September 18, 2023 to comment.

https://www.regulations.gov/document/FTC-2023-0043-0001.

Make sure you click on the comment button on their page. .

My text is “ I am in favor of the new rules the FTC is promoting. I want consumers to be protected. I especially want you to make sure that when hospitals or medical facilities merge that no services are removed from the facilities, especially reproductive services. I also want you to make sure that there is sufficient competition with respect to the availability of new medical treatments so that the consumer is the one who benefits. Thank you”

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

https://www.commoncause.org/find-your-representative/addr/

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Plan

Reproductive Health

NARAL - Pro Choice America

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.

If you need financial help with an abortion try abortionfunds.org

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water Resistbot write up