Sanders DiPiero respond to NY Times OpEd: "Blame Emergency Rooms for the Out-of-Control Cost of Care


In his recent Op-Ed contribution [Blame Emergency Rooms for the Out-of-Control Cost of Healthcare. September 5, 2018], Dr. Glenn Melnick astutely calls out that hospitals use their emergency departments to cynically fill hospital beds and inflate their own revenue through the use of “billed charges”, preying on the public’s need for emergency care. Dr. Melnick proposes regulation to cap billed charges at a percent of contracted rates. Such strong medicine may be necessary in such a dysfunctional system. But another option involves unleashing the power of disruptive innovation.

At the heart of the problem is the continued monopoly power of the hospital. Legislatures, regulators and communities have been fooled into protecting these outdated and wasteful institutions. Most healthcare can and should be delivered outside of the hospital, in smaller, leaner, technology-powered facilities. However, many states – like Oregon – still dictate that only hospitals may deliver emergency care – funnelling all patients to the most costly, least accessible point of care, wasting billions of dollars annually. For example, we estimate that opening up non-life threatening emergency care to emergency non-hospital emergency department alternatives that don’t charge facility fees would save Oregon Medicaid programs alone at least $50 million annually by delivering effective care in less intense settings, with far lower overhead.

Once hospitals lose their monopoly-protected status and must compete without subsidies and price supports, our healthcare system will reap a cascade of downstream benefits beyond direct taxpayer savings. Let’s combine Dr. Melnick’s good thinking about regulations with the power of innovation.

Albert DiPiero, MD, MPH Co-founder and Chief Medical Officer, ZOOM+Care

Dave Sanders, MD, Co-founder and CEO, ZOOM+Care

Read: Dr. Melnick's other work

Read: Sanders DiPiero review of the Emergency Room literature

Recent Posts

See All

Hi from HIMSS19!

By Albert DiPiero MD MPH I am at the annual HIMSS meeting in Orlando Florida this week. HIMSS is the Healthcare Information and Management Systems Society. A few quick thoughts: The sheer volume of he

CVS explores new concepts in healthcare

By Albert DiPiero MD MPH CVS - the drug store chain which is also one of America's largest retailers - is not waiting to see what Amazon is up to. CVS is pushing ahead transforming itself from retail

Amazon health venture hires CTO

By Albert DiPiero MD MPH The joint healthcare venture between Amazon-Berkshire Hathaway-JP Morgan Chase (ABJ) just announced the hiring of Serkan Kutan as its CTO. Mr Kutan was most recently chief tec