Health care is evolving into new forms that threaten core values in health care. First, mega-providers – larger and larger systems of health care delivery – threaten to dominate. The consequences of such systems will be explored to gauge whether their costs outweigh the benefits. Second, the financing of health care through private equity introduces new negative forces that may reduce quality of care in both hospitals and nursing homes, as private equity drives toward cost-cutting efficiencies and high charge models that destabilize and disrupt older system models. Third, regulators of health care cost and quality are falling behind. The favored regulatory models—information flow to consumers, transparency of care decisions—are limited in their effectiveness. The consequences of these forces will be considered, including disruption of the hospital-physician relationship; the escalating costs to Medicare and private insurance of mega-providers and private insurance; the weakening of physician and nurse power; and increasing levels of patient adverse events.
Recorded at the Health Law Institute in March 2022.