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Re: Hospital Governance



At 11:01 AM 12/03/1999 -0800, Don Coombs wrote:
>I have great difficulty believing there is no way for Moscow and Pullman
>to get together and operate just one hospital efficiently.

Personally, I don't think that a merger requires a single facility (not to 
say I'm against that, either).  A merger could still maintain separate 
facilities, while saving money by reducing duplication (oops!  the bean 
counters are getting scared now), by limiting purchases of major equipment, 
and by purchasing larger quantities of supplies at a time.  Instead of each 
hospital purchasing the latest, state-of-the-art equipment, only one 
hospital need have a cat scan, only one need have dialysis equipment, etc.

One of the reasons for high medical costs today is that each hospital in an 
area believes it must have the latest, greatest equipment in order to 
maintain prestige.  So although a region might only have enough patients to 
keep one cat scan busy, the region has three or for scanners operated by 
different hospitals.  In order to pay for the equipment, the doctors 
suddenly require a cat scan for every ache and pain.  The insurance 
companies, and consumers in the end, must pay for this duplication.

It is my understanding that hospitals are not exempt from antitrust & price 
fixing laws.  So it would probably be illegal for Gritman and Pullman to 
get together and say "OK, I'll buy one of these, and you buy one of 
those."  That's known as dividing the market.  But if they merged, a single 
administration could maintain separate facilities while deciding which 
facility was in charge of which specialization.

There is something to be said for having a hospital in each city 
(convenience of patients, proximity of emergency facilities), but for 
major, expensive procedures, I don't think increasing your trip by ten 
miles is asking too much.


Bob Hoffmann
229 East C St., Suite B
Moscow, ID  83843  USA
Phone: (208) 883-0642
Fax: 1-800-683-3799
http://www.alt-escape.com




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