Is Bigger Better?

The story of the “unification plan” for Memorial Hospital got me thinking about bigger. There will be a vote in November to decide whether to “unify” the local board with Maine Medical Center and it’s 8 subsidiaries, into one single board. The local board would continue to function for the next five years, and after that, any decision would require a 2/3 majority. A 2/3 majority – and they have 8 subsidiaries. How is one little hospital going to fare in that power scenario? They also say there are no plans in development to reduce services at Memorial.

Not at this moment. Plans can change, quickly. If anyone can think of a situation where giving up local control worked out well, please let me know.

I have the same checking account I opened nearly 30 years ago, in North Conway, in a small bank that was locally owned. The bank was swallowed up, repeatedly by ever-larger banks, and is now owned by a bank that is one of the 10 largest in the US.

The branch I do my banking in is populated by a constantly changing group of employees. It’s impersonal. The website of the branch doesn’t even list the name of the manager, as I learned recently when I wished to lodge a complaint about the service. It’s a much bigger bank than it was 30 years ago. Bigger is publicly traded and has shareholders, and that’s what matters, not customer service. Bigger is not better.

Nearly any company you call will have you wrestling with an automated menu that purports to direct your call. None of the choices will be what you want, and you’ll have to listen to the menu about three times to make sure of that. It sucks up a lot of your time, and it’s lousy customer service, BUT it means that no one need be hired to answer the phone and direct calls, so the company is saving money. The bigger the company, the more impenetrable the menu. The bigger the company, the less transparency and accountability there is.

The bigger the company the less they care about whether or not you do business with them. Customer service is not a priority. Look at what we tolerate from airlines.

The Telecommunications Act of 1996 paved the way for the giant media monopolies we see today. How do you like your options for cable? For phone service? How is your internet speed? Do you have lots of choices? The best customer service I ever had from an internet company was with a small company that served part of VT and part of northern NH. If something happened to my service, people would show up at my house within hours. They answered their phone themselves, too.

 How is bigger working out? We see this playing out in newspapers, where some corporate media group has mostly swallowed up the small, weekly papers in the top half of the state. In these scenarios the bottom line is the main concern. The news itself is in second place, and the employees a distant third. They all look the same and have the same bland tone.  

We see this playing out in radio. At the recent NHAB Granite Mike Awards, WMUR picked up most of the television awards, which isn’t all that difficult when you’re the only network station in the state. The big radio conglomerates won most of the radio awards. Congratulations to WMWV/WVMJ on their awards, and for surviving as the endangered species they are; independently owned commercial stations.

The more stations the company has, the more they all sound the same. I was spoiled by listening to WMWV for so many years, a station where, sometimes (in decades past) things could get a little unruly. It was not cookie cutter radio. The big corporate stations all sound mostly the same, with loud morning hosts bellowing inanities, and a lot of hyper compressed voices pitching ads. They are big. Are they better? Is money really all that matters?

Insurance is another area where we have corporate monopolies, especially health care. No one has ever told me how much they love their health insurance company. Health insurance is the greedy middle-man that drives up costs while providing nothing useful in the way of services. They often make your medical decisions – not you or your doctor. Because of them, doctors see patients on an assembly line, spending between 13-16 minutes with each of them. A study from 2016 showed doctors spending 27% of their work day with patients. The rest of their time is spent on documentation and paperwork. Health insurance companies and HMO’s have created an enormous, impersonal industry. They’ve also built monopolies. The relationship we have with our doctors and our hospital should be personal.

Memorial Hospital is of vital importance to the community. Think long and hard before surrendering local control.

This was published as an op-ed in the October 27 issue of the Conway Daily Sun newspaper