After Appalachian hospitals merged into a monopoly, their ERs slowed to a crawl
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Ballad Health, a 20-hospital system in the Tri-Cities region of Tennessee and Virginia, benefits from the largest state-sanctioned hospital monopoly in the United States. In the six years since lawmakers in both states waived anti-monopoly laws and Ballad was formed, ER visits for patients sick enough to be hospitalized grew more than three times as long and now far exceed the criteria set by state officials, according to Ballad reports released by the Tennessee Department of Health.
Tennessee and Virginia have so far announced no steps to reduce time spent in Ballad ERs. The Tennessee health department, which has a more direct role in regulating Ballad, has each year issued a report saying the agreement that gave Ballad a monopoly “continues to provide a Public Advantage.” Department officials have twice declined to comment to KFF Health News on Ballad’s performance.
According to Ballad’s latest annual report, which was released this month and spans from July 2022 to June 2023, the median time that patients spend in Ballad ERs before being admitted to the hospital is nearly 11 hours. This statistic includes both time spent waiting and time being treated in the ER and excludes patients who weren’t admitted or left the ER without receiving care.
The weird thing is this is the exact argument many people give for socialized medicine: the wait times. "Imagine if the hospitals were run with the efficiency of the DMV. A,trak, or the Post Office," meant as a negative slant. "Imagine if FedEx was the only game in town, and to mail letter was $10, and to receive mail and packages was a $25/mo service charge, plus fees for every item delivered."
God I wish hospitals were as good as those. You either make an appointment online or walk in, depending on what you need, get it done, pay a small fee, and go home. And with those services all the fees are published for you to review ahead of time. You go to the hospital, you're going to get hit with mystery fees from seven different directions. The room you sat in, the RN that took your vitals, the MD you saw, the machine that took your x-ray, and the radiologist to look at the picture are all going to get billed separately.
The last time I was at the DMV a few months ago I set up my appointment online and didn't wait at all. I'd grabbed the wrong document type so the clerk scheduled me for 30 minutes out and I drove home and back again and got my license updated with no waiting involved despite having made an error on my part.