Steve Bailey, a Boston Globe columnist, offers an interesting column in today's paper about the market power and the behavior of the largest hospital and physician group in the state, Partners HealthCare System. The head of that group makes a cogent and thoughtful comment (as he often does) about the ambiguity in today's society about its desire for greater cooperation among health care providers and its wish for a competitive marketplace.
With respect, though, the comment misses the point that Partners could be more cooperative, still maintain its dominance, continue to be financially healthy, and could also enhance the efficiency of the overall system. Instead, it rationalizes aggressive stances in the marketplace with a supposed need to ensure quality.
What I have learned in my short time in this field, though, is that no single hospital or system has a monopoly on good ideas to enhance quality and efficiency. When one group puts up barriers to cooperation, everyone loses an opportunity to improve.
As a student of other industries, I also humbly suggest that protectionist behavior by a dominant provider also removes a key stimulus -- within its own system -- to encourage behavior that enhances quality and innovation and customer service. Remember Ernestine, Lily Tomlin's telephone operator?