The problem is whether they really use their bigness to make things better, or if they just use it to generate higher revenue.
There is a lot of evidence that they are just using it to make revenue, that they are not that much more efficient or efficient at all because they are tied into a big mother shop that needs to be fed.
HLM: A lot of people are very optimistic about ACOs, value-based payments, and other changes built into the ACA. You don't sound optimistic.
ALTMAN: I'm not super negative, but I've been around a long time. I don't want to be too cynical. I believe ultimately the only way to slow the costs is to slow the revenue.
The healthcare system in America is a big money machine. I don't blame the hospitals; I don't blame anyone alone. But we are all a part of the big money machine and it is very expensive on a lot of levels.
If you compare American to other countries, it's not that we use too much healthcare. It's that the prices are much too high.
If anything, I think the American system is more efficient than Europe in many respects. We don't go to the hospital as often. We have shorter lengths of stay; we don't go to the doctor as much. But, what we do do is very expensive.
This is the second of two parts. Read part 1.
Tinker Ready is a contributing writer at HealthLeaders Media.