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Hospital mergers

Consumer group sees danger in hospital merger mania

June 7, 1996
Web posted at: 12:45 a.m. EDT

From Correspondent Jeff Levine

WASHINGTON (CNN) -- The epidemic of hospital acquisitions and mergers sweeping the United States is jeopardizing the quality of patient care, a consumer group charged Thursday.

The Public Citizen Health Research Group released a report suggesting that such mergers should be scrutinized more carefully by the government to prevent hospitals from cutting back on quality to save money.

Public Citizen's Dr. Sidney Wolfe said his group is most concerned about not-for-profit hospitals changing into for-profit operations. They say for-profit hospitals, in general, have a poor record in providing compassionate care.

"It's as though a McDonald's wants to buy up a mom-and-pop hamburger store," Wolfe said.

Hospital merger statistics

Wolfe's group finds this worrisome because statistics indicate that critically ill patients are more often "dumped" by for-profit hospitals than by not-for profits. Dumping patients in a medically unstable condition onto other hospitals is a violation of federal law.

Wolfe

The key question raised by Public Citizen's report: Will the former not-for-profit hospitals continue to provide expensive services, like caring for the sickest newborns, or treating AIDS patients, even after they're converted into companies meant to generate profit for their shareholders?

"For-profit hospitals are less likely to have these services than non-profit hospitals ... because they don't make money off these services," Wolfe said.

The report singled out the health care giant Columbia/HCA Healthcare. The chain owns more than 300 institutions, and 25 percent of the community hospitals in Florida.

Scott

In an interview two years ago, the operation's CEO said the profit motive doesn't necessarily conflict with taking care of the poor. In that interview, CEO Rick Scott said the new focus was on health care as a business. "Now in that business, we will do well because we are compassionate. We care about our patients," he said.

Some believe that Public Citizen's report is meaningless -- that given the pressure on hospitals to provide care for less, and reduce the number of empty beds, there may be fewer distinctions between for-profit and not-for-profit hospitals in the future.

"Competitive market pressures are going to tend, I think, to make for-profit hospitals and not-for-profit hospitals behave increasingly alike," said Henry Aaron of the Brookings Institution.

Nevertheless, critics say there needs to be some kind of community review process before a not-for-profit hospital goes profit. The American Hospital Association say it agrees -- as long as the federal government doesn't get involved.

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