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Will Federal Court Back Rules Treating Health Insurance as a Utility, Not a Luxury?

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On June 14, 2016 a Federal Court ruled that broadband internet is as essential to American as phones, electricity, water and sewer systems and should be available to all Americans as a utility, rather than a luxury that doesn’t need close government supervision.

In the United States, public utilities are often natural monopolies because the infrastructure required producing and delivering a product such as electricity or water is very expensive to build and maintain.  As a result, they are often government monopolies, or if privately owned, the sectors are specially regulated by a public utilities commission which severely limits the profits for the private utility company and the associated costs passed on to consumers of that utility.

There is nothing more essential to the lives and well being of Americans than health insurance and therefore healthcare is the ultimate utility.

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Size Matters: Hospital Consolidation and Physicians

As health reform evolves,  I’ve been watching multihospital systems grow in size and power and speculating what their gigantic size means.

Here, as of 2008, were the 10 largest systems in revenue size

1. Veterans Administration Hospitals,   $40.7 billion
2. Hospital Corporation of America,  $28.4 billion
3. Ascension Health, $12.7 billion
4. Community Health,  $10.8 billion
5. New York Presbyterian, $8.4 billion
6. Tenet Health, $8.3 billion
7. Catholic Health Initiatives,  $7.8 billon
8. Catholic Health West,  $7.6 billion
9. Sutter Health, $6.9 billion
10. Mayo, $6.1 billion

What strikes me about this list are that such giant systems like Kaiser, the Cleveland Clinic,  Johns Hopkins,  Duke, and Health Partners in Boston don’t even appear, and the large  number of Catholic multisystem chains.  The revenues of multihospital systems has undoubtedly grown since 2008.   In 2011, hospital  mergers and acquisitions hit an all time high.

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