by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
The government has filed a lawsuit against a hospital system in North Carolina about a problem that the government itself created.
Late last week, Attorney General Roy Cooper and the Department of Justice (DOJ) filed a lawsuit against Charlotte-based Carolinas HealthCare System (CHS) for prohibiting insurance companies from incentivizing their policyholders to seek care at competing facilities that provide services at a lower cost. This concept is formally referred to as “steering.” The plaintiffs argue that such anti-steering clauses illegally reduce competition in the health care market, a violation of the Sherman Antitrust Act.
An in-depth reading of the complaint elaborates on what steering vehicles insurers typically use to push patients to search for lower health care cost options. Narrow networks and tiered networks (top-tiers being those that bring patients the best value for their health expenditures by offering services at high quality and low cost) are just two examples. Apparently, Carolinas throws its weight around by not letting participating insurers formulate top-tier networks that include CHS competitors, or develop narrow networks that exclude CHS. The the state’ largest hospital system certainly has the leverage to do so – namely because they’ve captured 50 percent of Charlotte’s health care market and insurers may not be viable if they walked away from the monolith.
Some thoughts on this:
For more information on Certificate of Need, be sure to visit JLF’s restorehealthcarefreedom.com