…very informative piece about the North Adams Hospital (narh)…
he wrote this piece for the Boston Globe…
THE CLOSING of North Adams Regional Hospital highlights a big challenge facing health care in our state.
After the hospital closes, some of its services will be sustained, but others will be lost. Some physicians will stay, but others will retire or relocate their practices, further worsening access to care.
Over half of the Massachusetts hospitals open when John F. Kennedy was elected president have now closed. Not one that closed was a major teaching hospital. Heavy reliance on teaching hospitals helps explain our state’s extraordinarily high hospital costs. The pattern of closings may be partly responsible for that reliance.
Some might suppose that a functioning free market protects needed and well-run hospitals while closing unneeded and inefficient ones. Sadly, that pattern seldom prevails. Low-cost, efficient hospitals are not likelier to survive. But hospitals in wealthier places, with more patients insured by higher-paying insurers, rarely close. Some call this survival of the fattest.
A broken market is matched by ineffective government. Laws, regulations, and financing to protect all needed hospitals and their patients are weak.
Massachusetts state government should identify the hospitals, emergency departments, and other services that are essential to protecting the health of the public. It should act to ensure that needed institutions and services are paid enough to cover the cost of efficient provision of essential care.
Ultimately, the health care we all get depends heavily on the caregivers we’ve got.
The writer is a professor of health policy and management at Boston University School of Public Health.