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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.
I wonder, would socialized medicine more closely resemble a monopoly, or a competitive marketplace?
Neither since it’s not run for profit. Are state parks a monopoly or a competitive marketplace? What about playgrounds? What about the ocean?
It would be kind of fucked having a state run healthcare provider competing with itself, no?
Does that mean the state run healthcare would more closely resemble a monopoly? ie the scenario that produced this drop in service quality?
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.
Monopoly implies market. Healthcare isn’t a commodity to everyone who’s not a capitalist pig.
“It depends”. In a single payer scenario like they have in France, hospitals are private but patients are not forced to use a specific hospital chain because that’s the only provider that their insurance covers. The government acts as a counterbalance to try to keep prices low since they are the ones paying, and to keep quality higher since that’s another way of reducing cost for the outcome. A private vertical insurance/provider is incentivized to increase prices and reduce quality to improve profit.