Hospital mergers have not improved quality. But hospital mergers have raised cost. Every physician in America knows that you can increase your fee reimbursement dramatically by moving your contracts to a hospital “clinically affiliated” group. Giant hospital corporations simply have stronger negotiating power. The bigger they get the more fees go up, and those higher fees can be shared with the physicians they control. Oh, I mean “share data with.” That’s why independent physicians have vanished at an alarming rate. And that’s bad for America’s healthcare. A new, inexperienced physician should not be paid dramatically more by an insurance company simply because she joins a hospital staff instead of joining an independent practice. Independent primary care physicians have been proven to be the greatest value in healthcare and the best hope for reducing outrageous costs. A level playing field, with equal pay for equal work, should be demanded by employers, payers, and patients. Independent physicians must have the same fee schedule as hospital group physicians, or the massive mergers and increasing costs will continue. Let innovation, value, and quality be the path to greater reward, instead of market mergers and the power of size.