“Control healthcare and you control the people” –Saul Alinsky, Rules for Radicals
When the current resident of the White House–the former Vice President of the Obamacare era–signed his latest executive order (EO) on July 9, the push back from hospital organizations was fast and furious.
Joe Biden demanded the Department of Justice and the Federal Trade Commission review and revise their guidelines on hospital mergers “to limit harm to patients.”
The EO included 72 initiatives to ensure over a dozen federal agencies take on competition issues across the economy, including in health care. It also includes financial services, technology and agriculture.
His order establishes a White House Competition Council to coordinate, promote and advance federal efforts to improve competition in the American economy.
The EO, which does not have the force of law or regulation–that’s the responsibility of the Legislative branch to decide–but serves to provide direction to federal agencies.
It also incorporates a number of provisions directed at drug manufacturers, hospitals and health insurers.
“Thanks to unchecked mergers, the ten largest healthcare systems now control a quarter of the market,” the executive order said, pointing to the closure of rural hospitals as particularly concerning.
Biden’s Order Falls Short
According to the American Hospital Association President and CEO Rick Pollack, the “executive order falls short in several ways. For example, it does not recognize the exceptional value and essential services health systems provide to their patients and communities each day.”
“This has been highlighted during the public health emergency of COVID-19. The pandemic challenged hospitals to transform their operations, which included rapidly expanding telemedicine services, overcoming shortages of equipment and drugs, retooling operations and reconfiguring space to provide life-saving care for patients and protect others from contracting the virus.”
“Many hospitals were also called upon to backstop an inadequate public health response by providing information, counseling and vaccinations as those became available,” Pollack noted.
“Additionally, it is important to stress that hospital mergers and acquisitions undergo an enormous amount of rigorous scrutiny from the federal antitrust agencies and state attorneys general,” he continued.
“Finally, contrary to statements in the executive order, health systems can be a particularly important option for retaining access to hospital services in some rural communities. Mergers with larger hospital systems can also provide community hospitals the scale and resources needed to improve quality and decrease costs.”
Best Intentions Misguided
In a July 9 response to the order, Chip Kahn, president and CEO of the Federation of American Hospitals, said “The best of intentions can be misguided. Ensuring access to needed medical attention for rural Americans is not going to be assured by excessive antitrust enforcement action of the FTC or Justice Department. Miring hospitals in legal and bureaucratic red tape will simply slow critical care to the bedside.”