From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that may be of interest to our readers. Today’s post originally appeared on AL.com on March 17, titled “Guest opinion: Alabama hospitals need competition” In the op-ed, Richard P. Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala., discusses why the “game of Hospital Monopoly needs to end.”
Alabama is facing a crisis regarding hospital operating costs. Alabama hospitals posted a 79% decrease in operating margin from 2019-2022, putting rural hospitals at risk for closure. Total hospital expenses have increased by $2.6 billion from pre-pandemic levels, with Alabama hospitals spending 30% more on labor in 2022 than in 2019.
Dr. Menger argues that reform needs to break up the large hospital system mergers, acquisitions and consolidation. “This is destroying competition, limiting care options for patients, and burning out our physician and nurse workforce,” according to Dr. Menger. The solution requires reform, accountability and competition.
- The first solution is to reduce the administrative bloat of health care. Hospital executive salaries have far outpaced any physician salary increase, and reform needs to focus on the patient and the physician.
- The second solution is holding non-profit hospitals accountable when they receive government monies. Due to market consolidation, large hospital systems are everywhere in their community and can use that sprawling stature to manipulate the drug market.
- The third solution is to inject competition into the stale hospital-dominated system. Recent rulings have usurped non-compete clauses, allowing doctors to compete for wages in a regional market.
Click here to read the full op-ed by Dr. Menger.
Editor’s Note: Organized neurosurgery aims to improve competition in the health care system by increasing scrutiny of hospital and other health care consolidation, removing restrictions on physician ownership of hospitals and other ancillary services, establishing network adequacy standards and broadening health insurance coverage options.
In the recently released 2023 Legislative & Regulatory Agenda, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons outline health policy action items the neurosurgical societies plan to advance with Congress and the Biden Administration.
We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery.
As highlighted in a recent 
Dr. Wellons recounts how a colleague stood in an emergency department close to Sandy Hook Elementary years ago as the calls began to come in, he and his surgical team in medical gowns ready for the waves of injured children — waiting until they realized that no one survived to make it there. He concludes the article by saying, “Let me be clear, the death of children from any injury or any reason is heartbreaking, and the fact that gun-related death is the number one killer of our children, more than motor vehicle collisions and childhood cancer — what our medical journals have been telling us over the last few months — is a failure of our society and needs to be changed.”
Moments after Dr. Langer fell while skiing in Colorado, he realized he couldn’t move his legs, “I’m a neurosurgeon who can’t move, I thought. Now what?” After being airlifted to a Denver hospital, he was diagnosed with