This article first appeared in the Fall 2011 Issue of California Health Law News, a Publication of the California Society of Healthcare Attorneys.
Across the nation, America’s community hospitals are under siege. Once considered indispensible to our health care system, the twenty-first century finds the local hospital fighting an uphill battle against a convergence of factors that favors the sharing of resources by multiple facilities. Rising health care expenses, challenging regulatory hurdles, and a reimbursement structure in the midst of transition all bear some responsibility for the obstacles faced by today’s community hospital. Nowhere is this phenomenon more pronounced than in California, where regular hospital closings amid an ever-growing population stand as incentive for remaining hospitals to team up (or remain teamed up) under the potentially false notion that in modern American health care, there is safety in numbers.
Learning From Past Mistakes – What History Reveals About Health Care
Understanding the historical evolution of the American hospital is fundamental to recognizing the core problems faced by smaller hospitals today. From the 1736 opening of an almshouse in New York City (which would eventually become Bellevue Hospital) through the expansion to nearly 5,000 hospitals by the 1920s, and continuing through the post-1960 shift toward multifunctional facilities, health care has responded to the socioeconomic and political influences of each era. A trend of multihospital systems replacing freestanding community hospitals picked up speed after 1965, driven largely by a combination of economic factors (including the creation of Medicare) and technological advances in medicine. The five hospital consolidations noted in 1961 ballooned to upwards of fifty per year in the 1970s. By the 1980s, an estimated thirty percent of the hospital beds in the United States existed within hospital systems. … Read more →