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Reaction to Cain Bros. Report

Connecticut’s Healthcare Crisis & The Right Solution


HARTFORD, JUNE 6, 2024 — Connecticut has a duopoly healthcare system with Hartford Healthcare and Yale New Haven controlling approximately two thirds of the entire health care market. We have lost 21 independent, community-focused hospitals, leaving just six open. We have one remaining public hospital – John Dempsey Hospital– which is an essential part of the state’s flagship academic medical center, UConn Health. 

Connecticut patients are seeing the impacts of excessive hospital consolidation - higher costs, less accessibility, worse care – illustrated by a lawsuit against Hartford HealthCare claiming they engaged in a series of anti-competitive practices. The consolidation has also empowered the major health systems to hike up their prices for services and negotiate higher prices from health insurance companies. We’ve also seen profit-prioritizing behavior with a ‘centralization’ of rural services to their larger hospitals within the system to control costs like labor and delivery services. This not only poses a safety risk for these mothers and babies but fails to address the ethnic, racial, and economic disparities that exist in many rural communities.

Governor Lamont has the responsibility to support a public health system that serves all of Connecticut in an affordable and accessible way. Hiring a corporate-oriented consultant to make a recommendation to ‘fix’ our only remaining public hospital with more privatization and consolidation does a disservice to the growing population of patients that rely on UConn Health for their care. 

Governor Lamont’s report relies on outdated or incomplete data to draw inaccurate and misleading analysis which serve as the basis for the report’s recommendations. A properly investigated report would have started with the data, drawn an analysis and then created recommendations, but it’s clear the data and analysis was meant to fit the recommendations that were previously decided. 

It is clear that the report’s recommendations rely on numerous inaccuracies and omissions that misrepresent UConn Health's financial status and operational dynamics to reach a conclusion which is illogical - especially given the state’s current crisis with consolidation. The report emphasizes the importance of increasing the scale of UConn Health’s clinical operations, but exaggerates its small scale by comparing it with academic medical centers in states with much larger populations. 

When normalized to the population of other states, UConn Health moves to the center of the rankings for size of the patient care enterprise, similar in size to Ohio State, Penn State and University of Virginia, ahead of University of Illinois. Clinical revenues at UConn Health have more than doubled since 2010 with no signs of slowing. Despite the legacy fringe rates that the report mentions, external grant funding has grown by 60% from 2017 to 2023 with the normalization of fringe rates enhancing UConn Health’s competitiveness for research grants. We expect this growth in external funding to continue.

Further distortions include the convenient omission in the report’s public/private sector union benefits comparison is that private sector wages are often higher, and in Connecticut, the vast majority of private hospitals are non-union. So is the report suggesting that UConn Health workers should actually lose their union? Or does Governor Lamont want to risk strikes at UConn Health to settle labor disputes, which are now handled through neutral binding arbitration? The report also failed to mention the hiring bonuses and incentives that UConn Health has already had to offer to address its short staffing crisis (a situation which would worsen with benefit cuts).

In review of UConn Health’s role as a safety net for Husky patients, the report focused on hospital discharges and inpatient services only, neglecting to mention the importance of safety net care in outpatient settings such as mental health care, treatment for adults with sickle cell disease, poison control, and specialty surgeries, where for some patients, UConn Health is the only option - and for most patients, UConn Health is the best option. According to a peer-reviewed study conducted by Stanford University examining the effects of nearly 260 hospital privatizations, the most consistent outcome is a decline in access to care, especially for low-income Medicaid patients. Staffing levels also worsen, with an average 30% reduction in the number of physicians. Governor Lamont is so focused on generating independent cash flow, he is overlooking the broader benefits of state investment in public health, academics and research.

Governor Lamont’s endless pursuit of privatization and consolidation and dedication to prioritizing corporate interests over the needs of the community is a direct threat to the health and well-being of Connecticut’s residents. We need our Governor to value affordable, accessible and quality health care and stand up against the harmful and expensive impacts of excessive hospital consolidation. The patients of Connecticut deserve as much. Selling off UConn Health – whether we call in a “partnership” a “spinoff” or any other corporate buzzword – does exactly the opposite.

Even despite its intentions, the report provides further evidence of the critical role Connecticut’s only remaining public academic medical center plays in mitigating the negative effects of hospital consolidations. It also reinforces UConn Health’s status as a premier institution for health care, cutting-edge research, and top-tier instruction that trains a majority of the state’s physicians and dentists. So, in the language of Governor Lamont and the Cain Brothers, do Connecticut residents get a “good return” on the $30 they each invest per year to have a public hospital they own and control?  The finest hospital in the state by the Cain Brothers own estimation, and the sole bulwark against the increasing monopolization of Connecticut’s hospital industry?  Shouldn’t we do everything in our power to protect our public health system from corporate interests? We think so.

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