Of all the changes happening in the health care sector today – federal reform efforts, outcome-based medicine, etc. – perhaps the change with the potential to be most disruptive to Rhode Island is the purchase of Landmark Medical Center by for-profit Steward Health Care, a transaction it hopes to duplicate with other community hospitals soon.

Steward’s presumed plan to create a closed-loop, regional, care-delivery system could create an affordable alternative to the existing delivery/insurance paradigm. We would support such a plan and legislative efforts to help them achieve it.

However, it is important to recognize that such a system has the potential to draw patients away from existing tertiary care facilities, ones that at the moment form the core of Brown University’s medical-school teaching and research operations.

Given that the state’s leaders are looking to the educational/medical sector of the economy – the Knowledge Economy – to help pull the state out of its economic malaise, any new medical care model must be monitored to make sure that it doesn’t plant the seeds of a major deconstruction of the state’s economy. •