Stories like this are the reason I started this blog.  Image

There is a growing trend in the healthcare industry toward consolidation. The reasons for this are pretty clear – in the face of bloating administrative fees, increasingly complex medical coding and billing, and the incredibly difficult to interpret Affordable Care Act, it is becoming harder and harder for small, community-founded hospitals to stay in business. Small hospitals have less market share.

One solution has been to sell out. Small hospitals are being bought by larger hospital system (both for-profit and not-for-profit), as happened in my own hometown of Emporia, Virginia. Greensville Memorial Hospital became Southern Virginia Regional Medical Center, which is owned by a large, national for-profit hospital chain. According to the website, “Southern Virginia Regional Medical Center opened in December 2003 replacing the aging Greensville Memorial Hospital. The state-of-the-art, 80-bed, acute care medical center offers the latest healthcare technology to more than 50,000 residents in Emporia and the surrounding communities. Health services include inpatient, outpatient, emergency, medical and surgical care in a customer-focused environment.”

Let’s say you’re a pregnant woman. Maybe you didn’t realize you needed a “customer-focused environment” when deciding where to give birth (if you’re lucky enough to be able to decide).  Shortly after opening, Southern Virginia Medical Center closed its small OB department because it wasn’t profitable enough. Guess a customer-focused environment isn’t compatible with ushering new life into the world.

Considering the problems with consolidation, there is another surprising wrench thrown in – the Catholic church. Until reading this article, I had no idea that “Of the largest healthcare corporations in the country, five of six are administered by the Catholic Church.”  Catholic hospitals must abide by the Ethical and Religious Directives of the church, which have resulted in multiple situations that ended up with patient autonomy and preference tossed by the wayside in order to fulfill these top-down requirements that aren’t even in line with many patient’s personal beliefs or wishes. This article summarizes several of these situations quite nicely.  This article also details some of the context surrounding the merger.

I’m not trying to malign religious people, including Catholics. Many groups that identify as Catholic, such as the Catholic Worker Movement, have a long history of selfless devotion to social justice and alleviating suffering of those less fortunate.  However, we need to take a long, hard look at the conflict of interest that arises when Catholic corporations buy up smaller community hospitals and then dictate that those hospitals conform to their particular flavor of ethics, especially when they do not consider patients’ best interests or preferences.

More to come on this. The consolidation trend in healthcare right now is sure to have some implications that aren’t entirely clear yet.

MergerWatch is an organization which describes its focus as “We work directly with communities to find ways of protecting patients’ rights and access to care when non-religious hospitals are proposing mergers with religious health systems.” Definitely going to keep a close eye on this one.

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