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Sure. In many parts of the United States, regional hospital systems have captured their local markets through consolidation and exploitation of their non-profit
by tmoertel 2y ago
Sure. In many parts of the United States, regional hospital systems have captured their local markets through consolidation and exploitation of their non-profit status. They then offer their own health insurance plans to provide access their own hospital systems, sometimes even denying access to other insurance plans. So when these insurance plans spend on patient care, they are, in effect, paying themselves at rates they have strong influence over.
For example, in western Pennsylvania, there is UPMC. According to court documents, UPMC acquired 28 competitors between 1996 and 2018. According to the Pennsylvania Attorney General's office, in 2011 UPMC announced it would stop accepting patients insured by its competitor, Highmark. This prompted the PA government to "enter into consent decrees with both UPMC and Highmark to protect access to care." Which, again according to the Pennsylvania Attorney General's office, UPMC continued to violate. This has lead to, among other things, a recent antitrust lawsuit supported by the US Justice Dept. [1] [2]
[1] https://www.attorneygeneral.gov/upmc/ https://www.attorneygeneral.gov/upmc/
[2] https://www.wesa.fm/health-science-tech/2024-10-03/justice-department-upmc-lawsuit-health-care-monopoly https://www.wesa.fm/health-science-tech/2024-10-03/justice-d...
- consumer451 2y agoWow, that appears to be pure corruption. Thanks for sharing. I wonder if there are examples of this type of thing happening in places outside the USA, like Western Europe for example.
- consumer451 2y agoWait, I previously replied too passively. Yes, that is corruption. However, it is being punished! If a for-profit insurance/hospital group does this in the USA, taking money from patient care to profit... there is no punishment. Instead, it is encouraged. Correct?
- tmoertel 2y agoThe point is that both for- and not-for-profit systems can be exploitative and often are. And not-for-profits have extra avenues for exploitation. > Yes, that is corruption. However, it is being punished! In the example I shared, the evidence suggests that the punishment, as you call it, has not been adequate to solve the problem. And that problem has been ongoing for a decade and a half. And still continues.