National Nurses United urges Biden administrator to crack down on hospital monopolies

National Nurses United, the largest union of registered nurses in the United States, is calling on the White House to strengthen federal antitrust investigations and rules to reduce the harmful effects of healthcare mergers and acquisitions on patients, workers and communities.

“Consider a merger or acquisition in the healthcare sector, especially hospital acquisitions, to be anti-competitive. »

President Joe Biden recently ordered the Federal Trade Commission (FTC) and the Department of Justice (DOJ) to update their guidelines on horizontal and vertical mergers, which affect how regulators analyze potential transactions. anti-competitive. As part of the review process, the agencies have been listening to and accepting testimony and submissions from the public through Thursday.

In comments submitted earlier this week, UNN’s Senior Regulatory Policy Specialist, Carmen Comsti, wrote that “anti-competitive behavior in the healthcare sector through market consolidation is a health and safety threat. nurses and other healthcare workers and makes our patients sicker.”

The “employer monopoly,” Comsti said, “exacerbates problems with access to care and accessibility” for the public. For nurses and other health care workers, she added, it “depresses wages and dilutes the power of workers to advocate for better working conditions and patient safety.”

The FTC and DOJ, Comsti wrote, should “presumptively view any healthcare merger or acquisition, especially hospital acquisitions, as anti-competitive.”

In his hearing testimony, Kelly Tyler, a member of the NNU and nurse in Mission Healthcare in Asheville, North Carolina, described how the conditions of his community hospital deteriorated after the acquisition of the giant HCA Healthcare.

“Services like rural and wheelchair cancer care and seat clinics have been cut completely,” Tyler said. “HCA has shuttered primary care clinics and driven hundreds of doctors and nurses. Our most vulnerable populations have suffered, especially the elderly, who are often forced to drive more than an hour for necessary care. »

HCA, Tyler continued, has “taken its hatchet to charity care, geriatric services, security, and even hospital chaplains. »

“We believe HCA is using its market dominance over western North Carolina to drain our healthcare system and then send the profits back to Wall Street executives and shareholders,” she added, imploring the FTC and the DOJ to “amend…procedures regarding mergers and acquisitions.” to protect communities like Asheville from companies like HCA.”

UNN, drawing detailed comments from Comsti, elaborated on its concerns in a statement released Thursday.

According to the union: “Traditional distinctions between vertical and horizontal mergers have largely evaporated due to the abuse of market power by large health systems from the integration of corporate financial interests and control of different kinds healthcare institutions may encourage interference with professional judgment. practitioners and reduce the autonomy of practitioners”.

Citing Comsti, NNU said that “the role of the ownership of equity and” … strong tendency to focus on short-term profits, to maximize returns paid to investors and to minimize liability by funding Leveraged buyouts “have harmed patient outcomes and safety.”

NNU urged the FTC and the DOJ to pay particular attention to the “deleterious effects of private property in health care,” which, according Comsti, “is particularly damaging and even fatal.” She stressed that the inmates or health facilities operated by private equity firms tend to have “lower staff levels, higher health care prices and higher medical debt for patients.”

A report released last month shed light on the growing foothold private equity industry in the home health and palliative care sector.

“Health care market concentration is strongly associated with huge increases in predatory pricing practices by insurance companies and other payers and in hospital costs,” NNU noted. This contributed to “a national scandal over medical debt and…causing up to 40% of Americans to ignore needed care due to escalating costs.”

According to UNN, two-thirds of hospitals are now part of the multi-unit systems, against 37% in 1994. A NNU report published in 2020 revealed that US hospitals charge patients more than four times the cost of care, on average. Ratios higher-cost load were observed in hospitals belonging to multi-unit systems, the vast majority are run by for-profit companies.

“Health care market concentration is strongly associated with huge increases in predatory pricing practices.”

NNU Thursday explained that “conglomeration is increasingly visible when an acute care hospital system acquires or merges with medical practices, home health agencies, telehealth service providers, outpatient clinics, homes nursing homes, skilled nursing facilities or other post-acute care facilities. »

The union pointed out that this “frequently leads to reductions in inpatient services as well as higher prices for care”, resulting in “the increased shift of necessary care work to unpaid family carers or unlicensed aides, rather than to RNs and other professional caregivers”.

Following public testimony last week, FTC Chairman Lina Kahn said, “As we’ve heard from many of you, sometimes cost-cutting can come at the expense of quality of care. “.

On Wednesday, the Centers for Medicare & Medicaid Services (CMS) released data on mergers, acquisitions, consolidations and ownership changes in Medicare-enrolled hospitals and nursing homes from 2016 to 2022 – the first time that this information has have been made public.

Echoing analysis NNU on the harmful effects of mergers and acquisitions, CMS administrator, Chiquita Brooks-LaSure, said in a statement that “the consolidation of hospitals and care facilities leaves many underserved areas with health care options inadequate or costly. “

Comsti, for its part, also emphasized that market consolidation weakens the bargaining power of RNs and other health workers on conditions of employment, lowering wages and leading to unsafe staffing levels.

In addition to harming patient safety, she said, “the lack of intentional staff, lack of health and safety precautions and other poor working conditions have distanced nurses nursing at the patient’s bedside.

To limit the damage associated with mergers and acquisitions in the health sector, NNU urges the FTC and the DOJ “to extend the antitrust review and other guidelines by examining past practices of buyers, such as higher fees for payers and patients, hospital closures and reductions in patient services, negative impacts on independent hospitals and public healthcare facilities, past anti-union behavior and the degradation of patient privacy and data sharing. information with technology companies.

“These additional measures and remedies in the M&A guidelines,” the union said, “can protect patients, workers and communities.”

Comments are closed.