by Tony Chen

Well, if you're like me, you stayed up for a while watching the election coverage. 46 to 48... okay, 48 to 48... After clicking on the "refresh" button a few dozen times, I thought I'd actually do something constructive and think through how these elections will impact hospitals. As I sign off tonight, it looks like there will have to be a recount to determine the Senate while the Democrats will take the House.

The first way to think through this question is the same as everything else: follow the money. Look at the political contributions of several hospital trustees in NY to the democrats. While it might seem odd that this hospital wants a Democratic majority in the Senate, this is nothing more than a vote to remove our friend Senator Grassley from the Senate Finance Committee. If Grassley is out, then much of the increasing scrutiny on non-profit hospitals subsides. If Grassley stays on, you better believe that this contribution will bring more fire to his furnace.

Mostly though, hospitals don't take any particular stand except to provide pretty generic information about candidates. Look at this website from Ohio. AHA has a downloadable brochure that focused mostly on coverage for the uninsured, keeping Medicaid payments to hospitals.

At the end of the day, hospitals are looking for meaningful reform that doesn't have hospitals footing a disproportionate amount of the bill. Neither party has presented any meaningful long-term solutions. Thus, it's pretty much a wash. You could argue that in the short-term maybe democrats will be better at keeping Medicaid/Medicare payments up, finding funding for health for kids, and keeping big HMOs in check. And maybe Republicans will be better at keeping liability/malpractice insurance down, allowing hospitals to "compete" more freely, and setting up forward-thinking health IT policy. Republicans will also push consumer choice - more pricing transparency, more CDHP/HSA options, and more quality transparency - all part of this ownership society thing. your thoughts on whether hospitals should be wearing donkey or elephant caps?

The real story here is this: besides prescription drug prices, even though healthcare is still a huge issue for voters, it was virtually invisible for this entire election cycle. In 2008, I suspect much of the same. Maybe 2012? When patients start dying because their hospital died, that's when we'll start seeing some political courage.