Tweets that make me laugh

First this:

A few items later in my stream was this:

The latter references a new RWJF synthesis on the effects of hospital competition.  The key points:

• Hospital consolidation generally results in higher prices. This is true across geographic markets and different data sources. When hospitals merge in already concentrated markets, the price increase can be dramatic, often exceeding 20 percent.

• Hospital competition improves quality of care. This is true under both administered price systems, such as Medicare and the English National Health Service, and market determined pricing such as the private health insurance market. The evidence is more mixed from studies of market determined systems, however.

• Physician-hospital consolidation has not led to either improved quality or reduced costs. Studies find that consolidation was primarily for the purpose of enhanced bargaining power with payers, and hence did not lead to true integration. Consolidation without integration does not lead to enhanced performance.

For background, Providence was one of the higher cost providers Regence tried to cut out of their network, while Tuality was one of two low cost providers the insurer wanted to keep.  Despite providers being mostly successful in pushing back against that move, it looks like it still struck a nerve...