Maybe a better way to phrase it is that community hospitals don’t want to be subjected to unfair competition.

They amount to trying to drive the competition out of business.

The current regulatory environment forces community hospitals to participate in a gunfight armed only with a knife. I think that’s what the AHA is fighting.

True, the rules are uneven, but let’s keep in mind that the big hospitals are not asking for an even playing field. That is, they aren’t asking for some version of EMTALA to apply to specialty hospitals or rules against “cherry picking” (although the evidence that specialty hospitals do that is mixed at best.)

What big hospitals (such as the American Hospital Association) are asking for is a complete cessation of all physician owned specialty hospitals. They want no hospital to be more than 40% physician owned and no physician can have more than a 2% ownership. Those are the rules the AHA has been trying to slip into a host of bills on Capitol Hill, from Medicare Physician Fees, to SCHIP, to, now, Mental Health Parity.

Such rules aren’t “fair competition”. They amount to trying to drive the competition out of business–or at least prevent more competitors from entering the market.

I think the NHS illustrates the nightmare that results from the kind of “planned mix” that you advocate, Marc. NHS waste is the stuff of legend and the “war” is between the British people and the system that is supoosed to provide care.