Boston sucking in the health-care biz; better trains, please

Main entrance of Massachusetts General Hospital, in Boston. MGH is the flagship of Partners HealthCare.

Main entrance of Massachusetts General Hospital, in Boston. MGH is the flagship of Partners HealthCare.

It’s unclear what precisely is going on with the new talks among Partners HealthCare, the giant Boston-based  hospital system, and Rhode Island’s Care New England (CNE) and Lifespan. Partners of course has been trying to take over CNE, and now it may be trying to take over Lifespan, too. The participants’ statement that they are assessing how “they might work together to strengthen patient care delivered in Rhode Island’’ is smoke that may camouflage what might really be going on: a plan for Partners to take over most of the Ocean State’s hospitals.  (Who knows what might happen with South County Hospital, which is still independent. Westerly  Hospital is part of the Yale New Haven Health System.)

The effect of a takeover by Partners would be that much (most?) of Rhode Island’s health care  would be run from Boston, one of the most important medical centers on Earth. It would mean that, more and more, complex procedures for  Rhode Islanders’ very serious illnesses and injuries would be performed in Boston, because of the efficiencies of scale and the density of specialists there, and not in Rhode Island, which would offer mostly primary and behavioral- and mental-health care.

It’s unclear what the impact would be on the  Brown Medical School. Butler, Bradley, Hasbro Children’s, Miriam, Rhode Island and Women & Infants’ hospitals, as well as the VA Medical Center in Providence, are all teaching institutions for Brown. Partners’ facilities are teaching hospitals for the behemoth Harvard Medical School.  Tough competition.

A Partners takeover of CNE and Lifespan, besides providing very lucrative golden parachutes for CNE and Lifespan executives – bosses of enterprises being acquired love mergers because they make a personal killing -- would leave an enterprise with huge pricing power. You can be pretty sure that it would take full advantage of this by jacking up prices, just as Partners has done in Greater Boston. That has drawn much scrutiny from Massachusetts regulators and long investigative pieces from The Boston Globe.

Rich and powerful Greater Boston often seems to suck up a lot of oxygen in New England. Still,  overall, Rhode Island benefits from being so close to a world city, with its massive wealth creation and cultural richness. Indeed northern Rhode Island is  increasingly part of Greater Boston – a cheaper  residential and workplace option for people who need to be close to, especially, downtown Boston/Cambridge. Consider that Rhode Islanders will soon be able to apply for some of the 2,000 jobs that the increasingly monopolistic Amazon has just announced it will add in Boston, which is also still a candidate for the company’s much-hyped “second headquarters.’’ (Will the massive coastal flooding that seems to be an increasing threat to Boston’s Seaport District scare them away?)

The improvements in Boston-Providence MBTA commuter rail service promoted by a group called TransitMatters would improve the benefits to Greater Providence of being close to Boston. Few if any projects enrich a metro area like good mass transit.

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Among the organization’s many recommendations is for trains on the Boston-Providence line to run every 15 minutes at peak times and every half hour in off-peak times, as well as free transfers among commuter trains, buses and subways. The aim is also to cut the MBTA train time between Providence and South Station, in Boston, by, say 20 to 25 minutes.

This may all seem pie in the sky until you see that Europe and East Asia already have such service – actually, some of it is even better. A major reason is that they see  state-of-the-art passenger train service as crucial for the socio-economic health of their metro regions and are willing to levy the taxes needed to provide it, unlike in private-opulence-public-squalor America.