For nearly fifty years I worked for an electric and gas utility. Like other utilities, because there was no direct competition for delivery of this vital service (and it would be inefficient to do so), the company was highly regulated. The amount of profit that could be generated, when and by how much prices could be raised, major investments and much more were regulated and required prior approval.
In addition, the regulators frequently conducted independent audits of the company; cost structure, organization and overall efficiency of operations. Several times I had to justify spending on employee benefits, especially what we were doing to control health care benefit costs ( because all costs eventually affected customer prices). Every function was reviewed.
All this to be sure consumers were getting the best possible deal both for electric and gas services and the price they paid.
Now I ask you, why aren’t these standards applied to major hospitals and health care systems? What could be more of a public utility than health care? And no, there is no real competition in health care delivery and even if it existed, it would not drive the changes needed.
In all the debate about health care in America, the least asked question remains “why does this service cost what it does.” Rather, we remain focused on our insurance premiums.
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