The Business of Health Care
Washingon Post business columnist Steven Pearlstein's column today deals with competition—or the lack of it—in the field of radiation therapy in Northern Virginia.
Not content to have the lion's share of the hospital market in Northern Virginia, with profit margins that would make any for-profit hospital proud, nonprofit Inova has been aggressive in extending its near-monopoly to outpatient services. Not surprisingly, that is where the money is these days.
Radiation therapy, a common treatment for cancer patients, is one such area. This treatment often involves more than 25 visits to a facility where patients are put in a lead vault and zapped with radiation from a machine called a linear accelerator.
Under the state's medical facilities planning law, Northern Virginia has 14 such accelerators at eight locations. Nine are either at Inova hospitals, hospitals it has proposed to acquire or sites jointly operated by Inova. Only one is free-standing and independent -- Associates in Radiation Oncology in Fairfax City, owned by Dr. Anu Gupta.
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Earlier this week, the AMA issued a statement on competition—or the lack of it—in the Las Vegas commercial health insurance market.
"The conditional approval granted by Department of Justice for the acquisition of Sierra Health Services will do nothing to block UnitedHealth Group from gaining a stranglehold on the Las Vegas commercial insurance market. This acquisition is one more example of a health insurer mega-merger that will benefit no one other than health insurer executives and stockholders.
"The Department of Justice's decision to approve the acquisition of Sierra is a step backward, and allows United to consolidate unprecedented market power in southern Nevada. While the Department of Justice did attempt to protect vulnerable seniors from having to cope with a monopoly, it left several hundred thousand people vulnerable to a health insurer with clear track record of placing profits over patient care, insensitivity to local health care needs, and a selective sense of accountability to state regulators.
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It's a funny thing about competition. It's a pillar of capitalism, but actual capitalists seem to spend most of their time trying to eliminate it.