J. Nick Baird, M.D.
Director,
Ohio Department of Health
IN SUPPORT OF
House Bill 71
BEFORE THE
House Health
Committee
Mr. Chairman. Members of the Committee.
I am Dr. Nick Baird, director of the Ohio Department of Health. I am here this morning on behalf of Governor Bob Taft to voice support for House Bill 71.
As a physician who practiced medicine in the Greater Columbus community for more than 25 years, I am concerned about the rapid rise of physician-owned “boutique” hospitals. I recognize that the proliferation of these hospitals is not unique to Ohio. It is part of a national trend that is attracting the attention of government policy makers and private payers alike. It promises to be one of the most heated issues on state and federal policy makers’ radar screens in the months ahead.
What is unique is the solution around which this legislation has been built. First, it is a clear and simple solution – one that doesn’t cost any taxpayer dollars, doesn’t require any new staffing or the growth of any state bureaucracy and doesn’t call for any new department authority or regulatory activity.
Second, it is a solution that borrows from the public health profession, which understands that curing disease is only part of the answer. Winning over sickness is important, but far more powerful is avoiding or preventing disease in the first place.
That’s what Representative John Peterson and the co-sponsors of House Bill 71 are trying to do. They have identified the problem, which is physician-owned, for-profit hospitals that fragment the delivery of health care services and jeopardize community hospitals’ ability to serve the health needs of the entire community. With this legislation, they are trying to avoid – to prevent – a problem before it becomes a statewide crisis. It’s an approach that makes a lot of sense to me.
I understand why doctors are opening and investing in for-profit hospitals. Faced with the harsh realities of a changing health care industry, physicians are trying to gain clinical and financial control over their own work. I understand that, but I believe that this is the wrong answer to a challenging question.
These boutique hospitals are not good for patients because when things go wrong – when an elderly patient has a heart attack or stroke while undergoing a hip replacement – where are the essential back-up services, things like intensive or cardiac care, or emergency rooms.
This fragmenting of health care can be costly – both in terms of dollars and quality. It can endanger the lives and well being of patients.
But that’s only part of the problem. Physician-owned boutique hospitals are not good for communities and for the not-for-profit hospitals that are designed to meet the needs of all citizens.
By catering to wealthy and fully insured health care consumers, boutique hospitals leave the care of those patients who need the most complicated and costly care – and those least able to pay for health services – to community hospitals.
By concentrating on the most profitable and lowest-risk patients, boutique hospitals and the doctors who own them jeopardize the ability of full-service community hospitals to offer the full scope of health care services that their communities need. They undermine a community’s access to high-quality, affordable health care by drawing away from community hospitals the dollars they now use to help pay for such things as poison centers, free health screenings for children and pregnant women, trauma care, child abuse prevention programs and charity care for the poor.
And by referring people to in-patient hospitals in which they have a financial interest, doctors face the potential for serious conflicts-of-interest – the temptation to base medical decisions not on what’s best for the patient, but rather on what’s best for the doctor’s bottom line.
These are conditions that I do not want to see here in Ohio. That’s why I am here to voice my support – and Governor Taft’s support – for this legislation.
I urge you to support HB 71 for the health of all Ohioans.
Thank you.