Excerpt
When Congress passed the health care law, it envisioned doctors and hospitals joining forces, coordinating care and holding down costs, with the prospect of earning government bonuses for controlling costs.
Now, eight months into the new law there is a growing frenzy of mergers involving hospitals, clinics and doctor groups eager to share costs and savings, and cash in on the incentives. They, in turn, have deployed a small army of lawyers and lobbyists trying to persuade the Obama administration to relax or waive a body of older laws intended to thwart health care monopolies, and to protect against shoddy care and fraudulent billing of patients or Medicare.
Consumer advocates fear that the health care law could worsen some of the very problems it was meant to solve — by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses.
“The new law is already encouraging a wave of mergers, joint ventures and alliances in the health care industry,” said Prof. Thomas L. Greaney, an expert on health and antitrust law at St. Louis University. “The risk that dominant providers and dominant insurers may exercise their market power, individually or jointly, has never been greater.”
Lobbyists and industry groups are bearing down on the Federal Trade Commission and the Justice Department, which enforce the antitrust laws, and the inspector general’s office at the Department of Health and Human Services, which ferrets out Medicare fraud.
Those agencies are writing regulations to govern the new entities, known as accountable care organizations. They face a delicate task: balancing the potential benefits of clinical cooperation with the need to enforce fraud, abuse and antitrust laws.
“If accountable care organizations end up stifling rather than unleashing competition,” said Jon Leibowitz, the chairman of the trade commission, “we will have let one of the great opportunities for health care reform slip away.”
Congress’s purpose was to foster cooperation in a health care system that is notoriously fragmented. The hope was that the new law would push doctors, hospitals and other health care providers to come together and jointly take responsibility for the cost and quality of care of patients, especially Medicare beneficiaries.
Experts say patients can benefit from a network of care and greater coordination between doctors and hospitals.
(My post title is a paraphrase from one of my favorite PC game series, Fallout)
The "Army of Greed" (corporate lawyers, lobbyist, etc) are out in force to get more money by weakening (or killing) regulations that protect consumers/people. Profit before people.
Also note that what I call 'true HMOs' or 'HMO Health Care Providers,' like Kaiser Permanente (which I belong to) already do what "accountable care organizations" are intended to do. They run and own hospitals/clinics, pharmacies, and medical labs. The doctors and nurses are employees. Which is why, from what I see, they ARE more cost efficient AND provide better coordinated care. I have a very long view because my entire family has been with Kaiser since the 1960's and they have provided excellent care, including a wide choice of Primary Care Physicians.
This is in contrast to Health Insurance Providers, which the idea of "accountable care organizations" is intended to address.
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