|St. Alphonsus RMC|
One of the problems that the "let the market solve it" crowd - in the health care debate - has is that there's little real competition among many providers. And there's less and less all the time.
Most communities, of course, have only one major medical center. (And don't mistake this for an argument that we should be building more.) Increasingly, whole regions have but one, or maybe two, corporate organizations running them. Some are for-profit, some not-for-profit (though that term as often applied truly is a term of art), but the number of separate masters is shrinking. From a Wednesday press release from Trinity Health of Novi, Michigan:
Catholic Health Initiatives and Trinity Health announced today they have signed a letter of intent to combine their four Eastern Oregon-Western Idaho hospitals into a single local system. The agreement calls for transferring the three CHI facilities to Trinity Health, thus creating a new regional healthcare system to be operated by Trinity Health.
Three of the hospitals – Mercy Medical Center, Nampa, Idaho; Holy Rosary Medical Center, Ontario, Ore.; and Saint Elizabeth Health Services, Baker City, Ore. – are part of Catholic Health Initiatives (CHI) of Denver, Colo. The fourth hospital is Saint Alphonsus Regional Medical Center (SARMC) of Boise, a part of Trinity Health of Novi, Mich.
Trinity describes itself as "the nation’s fourth-largest Catholic health care system with 45 acute-care hospitals, 379 outpatient facilities, 29 long-term care facilities, and numerous home health offices and hospice programs based in seven states. Trinity Health employs 45,000 full-time staff, had $7 billion in annual operating revenue . . ."
Catholic Health Initiatives "operates in 20 states and includes 78 hospitals; 40 long-term care, assisted- and residential-living facilities; and two community health-services organizations. . . . With annual revenues of $8.2 billion, we rank as the nation's second-largest Catholic health care system." It has operations in Washington, Oregon and Idaho: In Washington, at Tacoma, Lakewood, Gig Harbor, Federal Way and Enumclaw; in Oregon at Ontario, Roseburg, Pendleton, and Baker City; and in Idaho at Nampa.
This is, of course, actually just a shift of properties from one mega-organization to another. But it does tend to further consolidate ownership control within regions. The celebratory tone in the release suggests, of course, that the people of the Northwest are meant to celebrate this.