Boston's MGH and Brigham and Women's hospitals are growing, adding new buildings and acquiring smaller hospitals. This growth isn't cheap. The massive $1. 9 billion expansion project on Cambridge Street is proof of that. But what's the cost to patients? With more market power, these big hospitals can charge more. Insurance companies might not dare to exclude these hospitals from their networks. This gives MGH and Brigham a lot of leverage when negotiating rates. The result? Higher healthcare bills for everyone.

MGH and Brigham are great for complex medical procedures. But their expansion into everyday care might not be the best idea. The Commonwealth could challenge this, but it's tough to stand up to powerful institutions. State and local agencies have some say, but they often back down. Even the attorney general has been careful not to ruffle feathers.

The real issue isn't a shortage of hospital beds, but a shortage of the right kind of beds. Patients awaiting discharge are clogging up hospital beds, preventing new admissions. Rehab centers are closing because they're not paid enough. The system is spending too much on the most expensive parts and not enough on the most effective.

Boston Hospitals' Expansion: A Double-Edged Sword

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