Today’s commentary wasn’t planned, but a morning report changed my mind. It disturbed me and it should disturb everyone who pays for healthcare – patients, employers and employees alike.
I get a daily journal of what’s happening in Dallas Fort Worth healthcare, and today it was reported that Baylor Scott & White Healthcare will open a new freestanding emergency hospital in the nearby suburb of Colleyville. This facility will be located 5 miles – a 10 minute drive – from the Baylor Scott & White regional medical center in Grapevine. They have a nice big ER there at the Grapevine hospital.
Baylor Scott & White is the newly created mega-healthcare system that certainly appears intent on becoming the local 900 pound gorilla. Recently it was reported that they are moving into alliances across Texas, as far away as Longview Texas to the east, and Midland Texas to the west.
In Wisconsin, five major healthcare systems are linking their affiliations – that will cover 90% of individuals in Dairyland.
Dr Richard Young, my friend and a fellow campaigner for saner care, wrote a piece intended for distribution to DFW employers who gathered last year to hear ideas about collaboration smarts. He wrote:
“I’m sure many of you have seen these freestanding emergency rooms popping up all over DFW like mushrooms after a hard rain. Ask yourself this: if you were thinking about opening a healthcare business and you could get paid $1500 in one facility or $100 in another for the same product, which facility would you invest in? This is not a facetious question. It’s exactly the dynamic that is driving the growth of these freestanding ERs, and the urgent care centers before them. A recent article in the (Fort Worth) Star-Telegram about one of the freestanding ER companies stated that the average revenue per visit is $1500, which is completely believable. Another source I know in the ER business told me that it only takes 8 patients per day for these things to break even.”
Within short distances in my own community of Flower Mound and the very next community over, there are four freestanding ERs, a new Texas Health Flower Mound hospital and right across the street from the new hospital, an emergency hospital put up by the nearby competing HCA hospital. Then, I think at last count, there are four walk-in CareNow clinics. And the profusion of new ologist offices along the growing medical corridor in Flower Mound is impressive. This is all within a 10 or so minute drive
There’s a term to describe events when an overactive thyroid-controlled metabolism runs amuck. That term is “thyroid storm”, and it is described as a very serious condition that can be life-threatening. By all stretches of the imagination, do you see this seemingly exponential expansion of facilities, hospital system mergers, and hospital systems gobbling up doctors’ practices like Pac Man as a threatening sign? It feels as though healthcare as gone from overactive to amuck. It’s dangerous and there is a bad moon rising. I recall from a population ecology course in college, that when there are too many bugs in a box, or too many lab rats in a cage, things start to get ugly. Are we there yet?
That’s why I coined the term “glut economics”, because the glutted health system is feeding more fuel into this healthcare revenue inferno. We hear and read all about the “system” (hospitals and insurance companies mainly) morphing into a new dawn of transparency and accountability. Is that bunk to make us feel ok? Yet all the while, we see insanity like these freestanding operations that are just huge moneymakers and hospitals grabbing up doctor practices to create subservient employees needed to feed more and more patients into the hospital mother ships.
C’mon – isn’t this a little scary?