Congress Needs to Support a Competitive Healthcare Market


With the 116th Congress actively discussing several healthcare topics, now is an opportune time to discuss how we can move our country to a truly value-based healthcare system that better serves patients’ needs. One of the most pressing issues affecting where and how patients access care remains the unchecked pace of hospital mergers and acquisitions. Not only are physicians like me concerned with this trend, most Americans are worried about the rate at which hospitals are purchasing independent physician practices, which they see as a threat to affordable care.

As a urologist who has fought for the rights of independent physicians for years, it is clear we can no longer allow hospitals to monopolize the conversation about care delivery, the organization of resources and the best reimbursement strategies. For too long, Americans have considered hospitals to be benevolent organizations more concerned with patient health and community service. The truth, as any informed observer of healthcare knows, is quite the contrary: hospitals are no different than any other business seeking to monopolize its service area and increase revenues. Multiple studies show that hospital consolidation in a market increases prices and reduces options for purchasers of health services, which includes self-insured businesses, insurers, government programs and individual patients.

For our patients, the increasingly rapid rate of hospital consolidation is leading to fewer and fewer options for care. Across the country, patients are less satisfied, less trusting and more concerned about the future of their healthcare than ever. In fact, a recent poll found that the majority of patients (65 percent) trust an independent physician to give them the best recommendation over those employed by hospital systems. Even worse, lesscompetition due to mergers has been shown to affect care quality. For example, Medicare beneficiaries who experienced a heart attack were more likely to die within one year of treatment if they were treated by a hospital that faced few potential competitors, compared to patients in the most competitive areas.

The lack of strong oversight from state and federal regulators has enabled large hospital systems to continue to merge with one another, open outpatient departments and acquire physician practices without regard for the long-term impacts. This has created a market in which independent practices cannot fairly compete and hospitals control where and when patients get care, and at what cost. That’s why Congress must take action to eliminate hospitals’ continued monopolization of local health services. Independently practicing physicians are not asking for favors or handouts. Rather, we’re asking for the ability to compete fairly. By leveling the playing field between hospitals and independent practices, Congress can ensure patients receive quality care at the site they choose at a price they can afford.

Time is of the essence. Congress has the power to address hospital consolidation by providing more aggressive Federal Trade Commission (FTC) enforcement of anti-competitive provider mergers and acquisitions.

Without the support of Congress, this issue will continue to spiral out of control, leaving patients (including your constituents) to bear the burden of less choice and higher costs. Congress must address the increasing trend of hospital consolidation before there are no independent physicians left and all we have are hospital monopolies controlling the quality and cost of care in America. Is that a price we’re willing to pay? 

Richard G. Harris, MD, is president of LUGPA, the only nonprofit urology trade association in the US. LUGPA provides resources for physicians to preserve and advance the independent practice of urology.

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