Taking Aim at Medical Profits 

Idaho's dominant daily newspaper and of its writers, Audrey Dutton, should be commended by the community for an Oct. 31, 2015 report on costly attempts by a local medical near-monopoly to expand its purchases of Idaho physician practices.

This recent episode. known as the "Saltzer deal," is based on court documents addressing Federal Trade Commission concerns. Dutton recounts the administrative and legal expenses now encumbering this near-monopoly and Saltzer's "business" operations.

The considerable costs associated with such wheeling and dealing apparently are not unique to Boise and even might contribute to our increasing medical costs. Now, instead of expressing contrition for its illegal overreach, this monopoly's supporters have begun attacking the presiding federal judge involved. Such arrogant behavior and attitude in our nation's medical-business communities largely could account for the increased costs for medical care in geographic areas such as ours dominated by medical monopolies as documented recently in one of the past year's JAMA articles: 2015; 314 (13): 1337-1338.

In 2012, a 17-year California study of medical costs associated with hospital consolidations found increased procedures (and costs) for patients. Further, consolidations conferred patients no improvement in quality, access or costs for their care.

In tandem, the medical insurance industry remains very profitable while it, too, is undergoing consolidation, amassing profits so large that last year the California Legislature, upon learning its state's Blue Cross had reserves exceeding $4 billion, revoked the company's nonprofit status.

Could not Idaho's pro-business legislature level the taxable playing field for the entire business community?

It is puzzling why our medical, business and informed lay communities remain so compliantly silent on these issues of medical quality and costs.

—F.W. Baur, M.D. (retired)

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