Hospitals

Morning Read: How hospitals drive up health costs

As hospitals, physicians and insurers fight to deflect blame for who’s most responsible for soaring health costs, new research from the Center for Studying Health System Change shows that plenty of fingers should be pointing toward hospitals. Research into six California markets shows that as hospitals and health systems grow in market share, the costs for health care accelerate faster.

Highlights of the important and interesting from the world of health care:

Hospital mergers significant cost driver: As hospitals, physicians and insurers fight to deflect blame for who’s most responsible for soaring health costs, new research from the Center for Studying Health System Change shows that plenty of fingers should be pointing toward hospitals. Research into six California markets shows that as hospitals and health systems grow in market share, the costs for health care accelerate faster.

As hospitals gain power and demand higher rates from insurers, health plans pass those costs on to individuals. Keep that in mind next time you hear about how one big hospital buying a smaller rival is a win for the local patient population. It’s tough to feel sympathy for insurance executives, but the following quote from one almost gets me there. It also makes the case for stronger government regulation of hospital mergers:

Losing faith in Big Pharma: Dr. Harlan Krumholz wants to believe that Big Pharma has patients’ best interests at heart. But the prominent cardiologist and Yale University professor is having his doubts after last week’s release of a Senate report based on internal GlaxoSmithKline documents concerning the company’s diabetes drug Avandia. The report showed that the company for years has publicly downplayed safety issues even as its own researchers internally voiced those same concerns. Worse, the company engaged in a campaign to discredit and intimidate critics who raised questions about Avandia’s safety.

The more this sort of thing happens, the farther Big  Pharma’s image falls. To Krumholz, the solution is easy: All data on a drug should be made public after the drug gets approved. Companies that fail to fully disclose that data should be slapped with big fines.

On all sides there should be a commitment to protect against the intimidation of academics who are willing to raise questions about the safety and effectiveness of company products. The free flow of information about the effects of drugs and medical devices will best serve the public’s interest.

House Democrats control fate of health reform: House Speaker Nancy Pelosi moves to center stage in the health overhaul/reform drama. If Democrats’ tentative plan is to have the House pass the Senate bill and then fix it later, Pelosi will have to be the one to deliver the votes. That won’t be easy since House Democrats are hardly a unified bunch. As many as 40 conservative Democrats voted for the House bill only because it contained restrictive abortion language that wasn’t present in the Senate bill, so Pelosi could be in danger of losing all those votes. Further, 39 other Democrats are fiscal conservatives who voted against the bill the first time around.

So even though last week’s summit may have given Democrats some political cover, we’ve still got a long way to go before the uncertainty surrounding health reform’s future begins to fade. Pelosi’s ability (or inability) to get her colleagues on board may end up as her defining moment as House Speaker.

Retail clinics struggling to survive: Once hailed as a glimpse into health care’s future, retail clinics are stagnating and struggling to survive, American Medical News reports. The clinics, which are often led by a nurse practitioner and designed to provide quick and basic primary care services, have seen their once soaring growth rate crawl to a near standstill. Key clinic operators like Walgreen and CVS have been closing retail clinics, and Wal-Mart has significantly scaled  back its plans. The problem, simply put, is that customer demand hasn’t matched expectations. Most clinics need to average two patient visits per hour to break even and many have struggled with even that small number.

The hope of retail clinics was that shoppers would become patients, and patients would become shoppers. There is little evidence that is happening. “Store traffic does not equal patient traffic — no ifs, ands or buts,” an industry consultant said.

[Photo courtesy of flickr user tahitianlime]