After Appalachian Hospitals Merged Into a Monopoly, Their ERs Slowed to a Crawl - KFF Health News
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Ballad Health was granted the nation’s largest state-sanctioned hospital monopoly in 2018. Since then, its emergency rooms have become more than three times as slow.

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Ballad Health, a 20-hospital system in the Tri-Cities region of Tennessee and Virginia, benefits from the largest state-sanctioned hospital monopoly in the United States. In the six years since lawmakers in both states waived anti-monopoly laws and Ballad was formed, ER visits for patients sick enough to be hospitalized grew more than three times as long and now far exceed the criteria set by state officials, according to Ballad reports released by the Tennessee Department of Health.

Tennessee and Virginia have so far announced no steps to reduce time spent in Ballad ERs. The Tennessee health department, which has a more direct role in regulating Ballad, has each year issued a report saying the agreement that gave Ballad a monopoly “continues to provide a Public Advantage.” Department officials have twice declined to comment to KFF Health News on Ballad’s performance.

According to Ballad’s latest annual report, which was released this month and spans from July 2022 to June 2023, the median time that patients spend in Ballad ERs before being admitted to the hospital is nearly 11 hours. This statistic includes both time spent waiting and time being treated in the ER and excludes patients who weren’t admitted or left the ER without receiving care.

  • Aleric@lemmy.world
    13·
    8 months ago

    Resemble a monopoly, yes, in the way a horse resembles a zebra. They might look similar but are decidedly different. Let’s break it down.

    Private care monopoly: having no competition to lose business to, cuts corners as much as possible, maximizing profits while degrading quality of service. Can be ostensibly held to standards of care by local authorities but, being the only option, can often tell them to piss off.

    Socialized hospital: being neither beholden to shareholders nor having a profit motive, has no financial incentive to cut corners provided the hospital is adequately funded. Funding is often contingent on achieving standards of care. Government can step in and reform underperforming facilities.

    Given your previous replies, I suspect I’m going to regret this comment, but I’m feeling like rolling the dice.

    • intensely_human@lemm.ee
      114·
      8 months ago

      Socialized hospital:

      being neither beholden to shareholders nor having a profit motive

      True. Let’s see how that plays out

      has no financial incentive to cut corners

      Unless there is anyone anywhere ever watching the budget. I’ve known government employees. They are cost conscious.

      provided the hospital is adequately funded

      la la land

      Funding is often contingent on achieving standards of care

      So a rough approximation of the free market’s natural incentives, except based on a central auditing committee instead of crowdsourced decision-making. So almost as good a system as a free market. Almost.

      Government can step in and reform underperforming facilities.

      Markets do this too. They do it faster, better, and with less coercion.

      • Aleric@lemmy.world
        91·
        8 months ago

        That’s a lot of words and quotes when it would have been a lot faster to simply say:

        “I am unable to contradict anything you said without pulling points out of context, completely disregarding others, and (my favorite of all) ending with a point that not only has been contradicted multiple times elsewhere, but is directly, stunningly contradicted by the very article we are commenting about.”

        Thanks for the laugh, mate. You yanks are drowning in your kool-aid while screaming at anyone offering help that you’re Olympic swimmers.