RSSCompetition by hospitals could be a good thing
Yakima Herald-Republic
E-mail
Print
More 'Opinion'
- Deportation? Let's use some common sense
- Valley voters never should be underestimated
- Forest Service needs to better plan, inform public of burns
- Tax credit will rev up first-time home buys over bleak winter
- Don't complain, do something about it-- Vote!
- Tuesday's election-- What we recommend
- R-71 is inconsistent, erodes sanctity of marriage
Start with the premise that free enterprise is a good thing; it's all-American and the basis of our economy.
Add in the idea that competition is the backbone of a free-enterprise system, and generally serves the competitors by making them more efficient while serving consumers by keeping costs in check.
Then sprinkle it with a philosophy that the government has a role in ensuring public health and safety -- but not in regulating what services should be available.
We're onboard with all of that, right?
Now apply those core beliefs to the question of whether two local hospitals should both be allowed to offer what has become a relatively routine elective medical procedure.
As it stands right now, only Yakima Regional Medical and Cardiac Center is permitted to perform elective angioplasty, a non-invasive procedure for heart patients to open a clogged artery.
The physician-recommended technique is a money-maker at $11,000 to $18,000 each. But under state Department of Health rules, as they exist now, only hospitals like Regional that provide backup, open-heart surgical capability can perform the elective procedure. The idea was that if something goes wrong and cardiac surgery is needed, a fully equipped and staffed heart surgery center should be readily available
That means that a mile away, at Yakima Valley Memorial Hospital, doctors can only perform angioplasty in an emergency. And that effectively shuts the nonprofit hospital out of most of the lucrative angioplasty market.
For Memorial, adding the well-reimbursed procedure to its menu of medical offerings would help offset the costs of items that aren't as well reimbursed.
But for Regional, any siphoning off of elective angioplasty patients would cut into its profits.
Enter the 2007 Legislature, which directed the Health Department to develop rules to lift the restrictions on elective angioplasty. Once those rules are adopted this summer, Memorial will apply for admittance to the elective angioplasty market and Regional officials are committed to convincing state officials that is not a good idea or even necessary.
Yakima is fortunate to have two quality hospitals, and we're going to let them wade through the red-tape snarl and make their cases for one or both having authorization to do the procedure.
But we can see why state lawmakers wanted to take a look at loosening things up as far as the backup surgery requirement is concerned.
There are 18 hospitals in the state that provide both angioplasty and cardiac surgery. Twelve others do only emergency angioplasty procedures.
In 2007, of 6,665 elective angioplasties in the state, 30 -- or 0.4 percent -- had to resort to follow-up emergency surgery. Those numbers were provided by the Foundation for Health Care Quality, a statewide nonprofit entity that focuses on designing quality improvement programs for hospitals. A spokeswoman for the foundation said it is prohibited from giving out hospital-specific numbers.
But if problems encountered by any of the 30 mentioned above had happened after a nonelective emergency procedure at Memorial, the patient could have been transferred to Yakima Regional.
There are some concerns, of course.
Duplication of services is not always a good thing. If the market is fragmented, it sometimes means that neither competitor is successful. Or it can mean that neither has the resources for improvements as new technologies become available.
On the other hand, perhaps care could actually be enhanced in a situation where two hospitals are vying for the same patients, in the process giving the patient a choice of hospitals. And competition might even affect pricing, to contain escalating health care costs at both hospitals.
Which brings us back to the free market.
Patient health and safety don't really seem to be the issue here, so we'll stand by our basic belief: The case has been made for opening up the market and against stifling competition.
* Members of the Yakima Herald-Republic editorial board are Michael Shepard, Sarah Jenkins, Bill Lee and Karen Troianello.
