The Sept. 23 editorial, “How best to confront monopoly pricing power,” rightly notes that hospitals don’t deserve all the blame for out-of-control healthcare prices. The problems are structural and the culprits abound: Even Big Pharma is but one among others. Consequently, the column seems to suggest that hospitals receive excessive scrutiny for relentless collection practices and nonstop merger activity.
Unlike other players, however, most hospitals and hospital systems claim not-for-profit status based on a charitable mission. As a result, they are given substantial tax benefits. Many also ground their mission in an admirable religious heritage that emphasizes compassion and generosity. Yet compassionate clinical care may be undermined by toxic billing and collection practices that threaten patients with financial ruin. These practices often inflict more lasting pain and anxiety than the illness or injury itself.
And when organizational conflicts arise between “mission” and “margin,” fiscal fear or sheer opportunism tend to win the day—even in systems already flush with cash. Other parties are surely at fault for much that’s wrong in healthcare, but hospitals should be held to their own higher standard.