Last year, hospitals and health systems underwent 98 consolidations, a 51 percent increase from 2010.  Many of these mergers and acquisitions arose in response to declining government reimbursement and the Affordable Care Act.  Smaller hospitals are having increasing difficulties maintaining a margin and many face high debt burdens, bankruptcy or even closure. But is consolidation the clear-cut answer? Here are 4 reasons bigger actually may not be better for all hospitals: 1. Disparate ...

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In the giddy days after the passage of ACA, I was chatting to a PhD student in health economics. He was in love with the ACA. He kept repeating that it would reduce costs, increase quality and increase access. Nothing original. You know the sort of stuff you heard at keynotes of medical meetings; "Healthcare post-Obamacare" or "Radiology in the new era." Talks warning us that we were exiting the ...

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Why hospitals have to dramatically change their missions I think I will become a neurosurgeon. Tomorrow. It shouldn’t be too hard, right? I’m a breast cancer surgeon, and that is kind of like being a neurosurgeon, isn’t it? I wear scrubs and know how to tie knots really well. OK, maybe I don’t know much about the brain, and the last time I was on a neurosurgical team was during ...

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Physicians must be the architects of health care changePhysicians must be the architects of health care change An excerpt  from The Myths of Modern Medicine: The Alarming Truth about American Health Care (Rowman & Littlefield). Myth 1: "The United States boasts the best health care in the world." Betsy Lehman trusted her life to the American health care system. An award-winning journalist, Lehman was a rising star at the ...

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One of the most pernicious lies about Obamacare is that it establishes “death panels” to ration needed care, especially care of seniors.  Although thoroughly discredited by independent fact checking sites, the death panel falsehood remains a staple of attacks on the Affordable Care Act. But it isn’t just that Obamacare doesn’t have death panels or anything remotely like them (the law actually prohibits denying benefits based on cost); we now have ...

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Is there really a doctor shortage, and what can we do about it? There is controversy about whether or not there will be a doctor shortage in the near future. I wonder why there is so much speculation. The Association of American Medical Colleges estimates that we will be short 90,000 physicians by 2020 and 130,000 physicians by 2025. If things stay as they are now, of course there will be a shortage. The ...

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Science bashing: The latest threat to research in America In the midst of multiple public health crises, the NIH budget is in an unprecedented period of stagnation. So why the growing chorus of voices calling to slash more science? Senator Rand Paul recently slammed the NIH, specifically calling out a study of “origami condoms” which he says are “designed with Japanese folding paper in mind.” In fact, this research is ...

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So there is this guy from MIT or Harvard, or some other place where they teach our leaders how to lead, and his name is Jonathan Gruber. Mr. Gruber, it seems, was hired to consult with the Obama administration during the time the Affordable Care Act (ACA) was created because of his extensive expertise in designing the Massachusetts health care system. In recent weeks, people who don’t particularly like our ...

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Jonathan Gruber went from unknown to infamous in the last few weeks, a result of disparaging comments he made about the Affordable Care Act (Obamacare) and even more disparaging ones he made about the American people. According to Gruber, the Obama administration counted on “the stupidity of the American voter” to pass the bill. In fact, the Obama team’s “lack of transparency” was deliberate, because they believed the law would ...

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Health cares future: An interview with a hospital CEO Not long ago I interviewed Dr. Todd Sorensen, the CEO of Regional West Medical Center, a 184-bed facility serving a large swath of rural western Nebraska. I've known Dr. Sorensen since junior high school, and we've kept in touch over the years to discuss the health care system from his perspective as a physician and administrator and mine as a health ...

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