Even before President Clinton's ideas for health care reform were brought to the nation's political agenda, it was clear to most in the industry that the cost and methods of providing medical care to our country's citizens had gotten out of control.
But the idea of growth and competition among the health care industry -- even if it possibly meant the reduction of those costs and greater effectiveness of the service -- has sparked controversy, depending on which provider or legislator you talk to.
State and federal governments have tried to establish regulations and even lofty national health care systems to control costs and create efficiency, but nothing has worked to date. And for many health care organizations, this has meant the opportunity to rethink the way health care is delivered in this country and possibly run it the way successful businesses in America have operated for years. These days, every hospital and health care system has to run on a fiscally responsible basis, in order to reinvest in its facilities, update technology, and pay its employees. The growth of managed care and capitated fee-for-service has caused everyone in this industry to re-evaluate their costs. Even the tax-exempt hospitals, which didn't have to worry about financial accountability in the past, are finding that they need to be more prudent in their spending and efficient in their systems. An integrated health care delivery system that can control costs through large vendor contracts, networked medical information and shared resources of numerous hospitals and facilities working together, means efficiency and quality patient care. Hospitals and health care systems that attempt to compete in this new world of patient care by running their operations more fiscally responsible have met with criticism from other health care systems, hospitals and certain public officials who see their growth as a threat to "business as usual" in a changing world. Even when met with the reality that government intervention to control costs hasn't worked, these critics still search for ways to improve health care efficiency without changing much of the traditional methodology. These past attempts on the part of government to control costs haven't worked. In the 1970s, the government attempted to slow the growth of health care costs by limiting the number and geographic distribution of health care facilities, equipment and services by enacting Certificate of Need (CON) regulations in each state. In 1974, the National Health Planning and Development Act was enacted by Congress, which required states to establish and administer CON regulations as part of the overall health planning process. This attempt failed over time. In 1982, when Congress realized that CON had failed to meet its health planning and cost containment objectives, the CON requirement was repealed. Since then, 17 states have totally repealed CON programs and several others have removed CON requirements for hospitals. Oklahoma was one such state to remove the hospital portion of the CON requirement. A recent attempt in Oklahoma by one state senator to re-establish CON requirements in the state has been tabled thus far. The Oklahoma Hospital Association has gone on record as publicly supporting the continued repeal, so it looks as though, for the time being, Certificate of Need is still not the answer for controlling the cost of health care in Oklahoma. CON aside, critics of systems attempting to grow in this state are still wary of expansion. These critics are doing a disservice to our state's citizens, however, by perpetuating myths that are not accurate. The idea of competition in a free marketplace is a sound one which is the very backbone of our country's economic system. Competition makes us stronger, provides more choice and greater quality for the consumer, and brings out the best potential of each player. …