Harriet S.MeyerMD, Contributing EditorDavid H.MorseMS, Journal Review EditorRobertHoganMD, adviser for new media
by Thomas P. Weil, 368 pp, $47.50, ISBN 0-472-11193-0, Ann Arbor, University of Michigan Press, 2001.
This book is certainly a keeper, one to be quoted for a decade. The question posed by the title and subtitle is whether health networks are good things to create. After a lifetime of working with a hundred hospital mergers, this consultant/author praises health networks with the faintest of damns: "There are reasons to believe that health networks can make some kind of difference, but right now and in the foreseeable future they are not expected to make nearly enough."
Dr Weil is in a position to observe that the main motive for creating most current networks is to achieve local monopoly power in the health field, using it to maintain higher reimbursements, charges, and costs. Since the current merger mania flies the flag of superior efficiency through consolidation, the real purpose could be pretty bad news for people footing the bills. The author delicately suggests that such motivation might even seem reprehensible to some, although to prospective participants his main argument is that it just doesn't work. Merging institutions with oligopoly as a goal routinely creates great clouds of uproar, but in the end the adventurers can consider themselves pretty lucky if they barely maintain previous levels of quality and don't lose much money.
NetworksHealth Networks: Can They Be the Solution?. JAMA. 2002;287(14):1863-1864. doi:10.1001/jama.287.14.1863