The reference to a "kick-butt approach to competitors" in your April 1 editorial (p. 28) was amusing. The real competitor for the healthcare dollar, however, isn't necessarily the hospital in the next town-it's the insurance industry.
Rather than "taking or leaving" deals offered by insurers, as suggested by Charles Ricks, the healthcare industry is integrating for a future in which direct contracting with the true payers will become increasingly common. The real battlefield in the coming years will be between providers and insurers. As providers, we need to answer the question: Is the middleman really necessary?
Chief executive officer
St. Mary's Kewaunee (Wis.) Area Memorial Hospital