Last Tuesday, the Office of Health Care Access (OHCA) held a public hearing regarding the Yale New Haven Health System’s proposal to take over Lawrence and Memorial Health. A very diverse cross section of the Greater New London community raised significant concerns about the impact of this consolidation on health care costs, access to health care services, and real local control over our community hospital. I share their concerns, and believe this deal should not be allowed to go through until we have real protection against high health care prices charged by the state’s fast-growing health care corporations.
I live in Waterford, and L+M is my community hospital. As a union member, I’m lucky enough to be offered decent health insurance through my employer. Until recently, my family’s health has been good and healthcare costs were not a big concern.
Although my company provides what many people would consider good coverage at a fairly reasonable cost, that coverage cost is growing fast. Where once the employee had a small premium and a modest co-pay, coverages have changed to require higher premiums and deductibles. Although co-pays are gone, the employee is now responsible for large deductible payments before insurance coverage kicks in. Out of pocket expenses have increased greatly, as I found out the hard way.
Upon a recent diagnosis of a medical condition, my specialist ordered a CAT scan to provide more detail prior to surgery. Since he is affiliated with L & M, he suggested the test be performed there. I called and scheduled the test and later heard back from the billing department informing me of the anticipated cost. I was shocked to hear that after my insurance paid a portion of the cost, my responsibility for the 10 minute test would be over $1,500.
That drove me to do what all the experts tell us we’re supposed to do – research what the typical price would be and determine if the procedure was provided elsewhere in the area. Little did I know that I would run into L+M’s growing empire in Southeastern Connecticut.
According to a medical cost website, the procedure should average around $600 to $800. I called Southeastern Imaging Center in Waterford to ask their price and their response was that they had been bought out by L & M and the cost would be the same as at the hospital, or the Pequot medical center, which had also been consolidated under L+M. The procedure would be billed at $1,644 before I received the “discounted” rate of $1,520.
Many of us think of L+M as a local community hospital. But like so many providers, a few years ago L+M decided to become a regional corporate player. All of a sudden they own Westerly Hospital, which they bought out of bankruptcy, they’ve taken over dozens of doctors’ practices and own their own home health service, the Visiting Nurses Association.
Those of us who with benefits that require ever-higher out of pocket costs are struggling to keep up as L+M buys independent facilities and jacks up the prices.
Imagine what could happen when Yale-New Haven takes over and dominates the shoreline from New York to Rhode Island. Competition is the key to holding down cost, which is either paid by individuals or shared by groups through higher and higher premiums. Recent studies have shown that high prices charged by providers rather than excessive healthcare usage is the major driver in rising healthcare costs in the private sector.
More competition, not less, is needed to put the cost of services in line with market costs; less competition only lines the pockets of the board of directors at those mega healthcare institutions.
We’re already seeing the dangers of consolidation. In December, preparing for the acquisition, L+M cancelled its affiliation with the prestigious Dana Farber Institute in Massachusetts. Of course, Yale’s Smilow Cancer Center also gives us access to world-class cancer care, but why can’t L+M keep relationships with both institutions? Maybe making the two giants of cancer treatment on either side of us compete might slow the cost of high-end subspecialists, and improve the care we get.
Let’s keep Lawrence and Memorial a true full service community hospital.
Ken Rowland is First Vice President of the MDA-UAW Local 571.