The increasing consolidation of hospital systems in North Carolina and elsewhere is said by the big players such as WakeMed, Duke and UNC Health Care to be beneficial to patients because of more services and more specialties. That sounds good, and to some degree it is good.
The question is, at what price do those services come? For as News & Observer and Charlotte Observer reports have shown, nonprofit hospitals offer comprehensive care at a high price, including the drug charges that are as much as 10 times cost. And consolidation, while it can mean better services for many, in the long run can reduce choices. If, for example, a big hospital system buys up a number of doctors practices in an area, and some patients have insurance that limits their choices, they may have to find new doctors.
Consolidation also gives hospital systems more and more control over pricing, which as the newspapers reported, can vary widely.
Americas health care system is undergoing radical change under health care reform, and a lot of that change is going to be positive in terms of more people being covered and pre-existing conditions not being a factor in insurance coverage, etc. The pre-reform system has seen the country spending a far larger percentage of its gross domestic product on health care than it should, larger than most other industrialized nations.
Reform of costs, and that means hospital costs, should be part of changes. Toward that end, the ongoing consolidation of hospital systems is something that federal regulators and Congress should watch closely for its impact on a group of people who sometimes seem left out of the discussions of health care: patients.