Health for Dollars

Medical Monopoly?

Some years back there was news being bandied about that Central Baptist Hospital in Lexington was looking to build a hospital here in Somerset that would have placed it in competition with the local privately owned hospital. This was before Lake Cumberland Regional Medical Center did the big add on that included more space and a parking garage. Speculation is that there was activity on the part of the owners that quashed the Certificate of Need application by Central Baptist after which the local hospital felt it profitable to go ahead with the remodel and add on.

The Certificate of Need is one of those things that governments use to grant de facto monopolies to medical establishments, ostensibly to protect their investment in infrastructure. They prevent a market from being overbuilt which would create competition in pricing which would make it more difficult to retain a high profit margin.

Monopolies are commonly granted to certain industries in order to induce them to provide services in a defined area. For instance, Kentucky Utilities and RECC are granted monopolies to provide electricity. Waste Management is granted a monopoly for garbage services, Windstream is granted a monopoly for land line telephone services and Newwave is granted a monopoly for hard wired cable services.

There may be instances where these monopolies may be required in order to induce investment in infrastructure but are they in the best interests of the public in the long run?

There is widespread discontent with Lake Cumberland Regional Medical Center about its quality, pricing and customer service. I do not mean to accuse that hospital of being of radically inferior quality but I do want to raise the question of whether or not we should allow another hospital to build in the area in order to introduce competition.

It is my experience and my opinion that for most serious medical problems that better service can be obtained in Lexington, Louisville or Nashville for equal or less money. I want to emphasize here that I am speaking only from my personal experience and from anecdotal evidence provided to me by other dissatisfied customers of Lake Cumberland Regional Medical Center. I do not have access to actual legal or financial records with which to definitively support my opinions.

When my father was battling Leukemia he received an injection of a drug known as EPO that promotes the growth of red blood cells. It was a very expensive injection and at Central Baptist or at the office of his oncologist in Lexington the cost of that injection was 2/3 of the cost at Lake Cumberland Regional Medical Center. I have noted this to be true for many other treatments and services my family has required. In addition, I have been told that this is true for a number of people with whom I have spoken.

It is not uncommon to spend half a day in a doctor's office even though you may have an appointment. When my father would complain of making the trip to Lexington for services I would tell him that we can drive to Lexington, see a doctor and be back in the length of time it would take us here in Somerset. I have speculated as to the cause of this phenomenon and I suspect it is due to over-scheduling. Why that happens is anyone's guess. Causes may range from simple opportunity to a high ratio of Medicare and Medicaid patients requiring a high turnover in patients seen.

Then there is the anecdotal evidence provided of inefficient, improper and downright dangerous treatment they received here at Lake Cumberland Regional Medical Center. I am aware that one chiefly hears of the negative experiences more than the positive ones and I want to be clear that I have heard of many positive experiences here at Lake Cumberland Regional Medical Center. What I really want to address is the desire of many and the efficacy of allowing another hospital to build a facility here in order to introduce the efficiencies of competition.

With the denial of the Certificate of Need for the Central Baptist effort there were many rumors, which I find believable, of political manipulation of the requirements for the CON. It is my opinion that competition, if allowed, would result in improved care and more affordable options. Lake Cumberland Regional Medical Center has been accused of inadequate staffing and I think that is plain to see. Inadequate staffing results in not only inferior care but also increases stress on the care providers who become burnt out and more blasé about their work. Competition would require that this be corrected.

In Lexington just in the past ten years we have seen massive improvements and additions at the University of Kentucky Medical Center, Central Baptist and St. Joseph's Hospital. There is a new hospital at London affiliated with St. Joseph's. It should be noted here that of the hospitals mentioned in this column that Lake Cumberland Regional Medical Center is the only privately owned facility. It is no secret that privately owned hospitals are chiefly beholden to the stockholders and are in business to earn a profit. Of course, every facility yearns to operate in the black but with being essentially non-profit and having support from other entities they can lessen the need to show profits to stockholders. Lake Cumberland Regional Medical Center is right to fear such competition but is this sufficient reason to deny competition from other facilities? I think not. Those that assert that healthy competition is required to achieve cost savings should be for a competitive hospital in Somerset.

I am interested in any accounts you may have of your experiences at Lake Cumberland Regional Medical Center. Please include enough information that your account may be verified. Please write me with either negative or positive comments. Perhaps we can get the ball rolling on another hospital to create competition and which will allow us to reap the benefits of that competition.

My take on the need for another hospital.