“Healthcare in the United States is in the midst of a massive wave of consolidation. For example, fifty years ago, virtually all non-academic, non-government U.S. physicians had an ownership interest in their practices. Today, approximately 70% of U.S. physicians are employed by hospitals or other corporate entities. Likewise, mergers and acquisitions have landed more than 70% of hospitals and 90% of hospital beds in multi-hospital health systems. As such, health care organizations have increased in size and their complexity has multiplied. For example, between 1975 and 2010, the number of U.S. physicians roughly doubled, but the number of healthcare administrators—employees of medical practices, hospitals, and health systems who do not directly care for patients—increased about thirty-six times.”
-Richard Gunderman, “Why Bigger Isn’t Necessarily Better: A Swiftian Perspective.” econlib.org. June 5, 2023.
This is an interesting essay. One direction that I would have preferred to explore is how does moving from an owner to an employee to a bureaucratic organization impact physicians? There is a move toward a different model, where people pay for a physicians services on a subscription model. How does the physician/patient relationship change when a family purchases a subscription? What happens when you strip out the bureaucracy of insurance, hospital systems, and so forth and cut down all the unnecessary documentation that comes with them? What happens when the physician knows the costs and has their name on the door? Does quality go up? I would imagine so.
cafebedouin.org 