BY KEVIN ST. JAMES
When patients in New Hampshire seek medical care, they expect fair prices and high-quality services. Unfortunately, our current health care system is failing them. Large hospital systems are buying up smaller hospitals and independent physician practices, leaving patients with fewer choices, higher costs and limited access to care. Without real competition, hospitals can charge whatever they want, and Granite Staters are paying the price. It’s time to fix this broken system and put patients first.
Across the country, nearly 70% of doctors are now employed by hospitals or corporate entities, meaning only 30% still operate independently. This shift has been especially harmful in states like New Hampshire, where major hospital systems dominate the market. When competition disappears, these hospital giants drive up costs by adding excessive fees and inflating prices. In fact, hospital prices have skyrocketed by 31% since 2015, making it harder for families to afford the care they need.
Not in my New Hampshire, right? Think again. Let’s examine the Exeter Hospital situation. Beth Israel Lahey Health (BILH), one of the largest hospital systems in New England, bought out Exeter Health Resources in 2023, and the announcement came with a pledge for “a $375 million capital commitment from Beth Israel … $10 million over 10 years to the state for projects that benefit health care consumers.”
However, one year later, a Seacoast Online story revealed what I would describe as an overhead reduction strategy: “…at the local level, hospital leaders have identified opportunities to restructure staff roles, including eliminating some positions, to best meet local health care needs in a sustainable way.” The hospital has since paused cuts to staff and services solely to give the New Hampshire Department of Justice six months to review whether the proposed reductions align with the stipulations of Exeter Health Resources’ merger agreement with Beth Israel Lahey Health of Massachusetts, dated 2023.
Executive Councilor Janet Stevens has been on the front line fighting for Exeter residents and constituents, describing Exeter Hospital’s decision to temporarily halt staff and service cuts for six months as “disingenuous.” I applaud her for standing up to a giant like BILH; she could have easily overlooked this issue, as many others have, but instead, she took a firm stance and insisted on accountability and transparency.
Another example of how hospitals in New Hampshire are driving up costs for patients by exploiting unfair pricing practices is through the use of “facility fees.” When hospitals acquire independent doctor’s offices, they start charging these extra fees, even though the care remains the same. This practice increases costs without adding value. New Hampshire Senator Maggie Hassan, has worked hard to expose and curb these anti-consumer practices, earning her the appreciation of Granite State patients.
Adding to the problem is the lack of price transparency. Studies show that hospitals mark up prices by an average of 300%, yet many still refuse to disclose their actual costs. Patients deserve to know what they’re paying for, yet hidden fees and surprise bills continue to leave New Hampshire families drowning in medical debt. Enforcing federal price transparency laws is critical to ensuring patients have the information they need to make informed health care decisions.
So, what can we do to address this issue? We need to promote hospital competition by preventing monopolistic hospital systems from taking over local markets. By encouraging more independent health care providers to operate in New Hampshire, we can increase competition, improve quality and lower prices for patients. We must enforce federal price transparency laws, so hospitals can no longer hide costs from the public. Finally, we need to rein in hospital price markups and eliminate unnecessary facility fees that drive up costs without improving care.
Health care in New Hampshire should work for the people, not against them. We need policies that protect consumers, encourage competition and ensure that hospitals put patients before profits. It’s time to take action and create a health care system that truly serves Granite Staters. We are asking the New Hampshire federal delegation to continue advocating for hospital transparency and good-faith billing practices, and to ensure a healthy, competitive health care provider marketplace in the state.
Kevin St. James is a FF/AEMT and former state representative, county commissioner and selectman in Kingston, NH.
