Essay On Competition In Healthcare

Competition exists in healthcare. Just drive down the road and count the billboards that are related to a health system or company providing health and wellness goods and services. Healthcare is a right, just review the present EMTALA laws and look at your pay stub. Since this duality exists, how do we balance the competitive nature and the social responsibilities?

Competition is driving consolidation. The market power is then used to drive higher prices. This market-driven approach is counter-balanced with regulations and review by the Federal Trade Commission and Office of Inspector General to protect the public. This on-going back and forth will never be managed by law entirely as there is no way for enforcement agencies to stay ahead

Almost immediately, in the attempt to consolidate, these services are placed under a hospital outpatient department (HOPD). Makes sense as why would you have two different agencies doing the same thing? However, the HOPD collects a much higher payment for the service as they are “allowed” to under hospital pricing regulations as a method to offset the higher cost of hospital services. In this scenario, the price of a “product” goes up even though the location and service provided do not change. Playing this out, we are now beginning to see payers saying they will not pay these higher fees. A battle created by consolidation.

Single system providers in rural markets and academic systems that only provide highly specialized services are two other areas where market forces have led to higher costs for similar services that could be found elsewhere. There definitely should be a premium for services that cannot be obtained otherwise, but to what level? Should an academic center be able to charge inflated prices for services that are common to a market just because they own the ability to due transplants are provide trauma services? When the cost of services rises, individual members of our societal community will go