When Your State Creates a Medical Monopoly

Dani Cook
3 min readJan 3, 2022

Yup, you read the title right.

The state of Tennessee (and Virginia too, to be fair) created a legal medical monopoly and we are approaching the four year anniversary of its official launch.

Now, you might be wondering how they did such a thing when the Tennessee State Constitution specifically prohibits the existence of monopolies.

Good question.

Let’s talk about that.

First, you need a savvy, politic-friendly, healthcare executive with an ego big enough to risk his entire career on something that has never been done before.

It helps if he’s been on 60 Minutes in the past because of questionable practices in his last healthcare system and has proven his ability to face intense media and government scrutiny and come out virtually unscathed. (Although his last company wasn’t so lucky.)

Second, you need state politicians willing to change the state law and include verbiage that not only protects the new monopoly but also requires citizens who wish to challenge the new law to pay an appeal bond in order to exercise their constitutional right to due process.

Third, you need a group of local businessmen, who also happen to control 65% of the region’s employment, who are willing to recruit letters from local businesses in support of this medical monopoly, and who are willing to speak at the public hearings required by the TN Department of Health before the monopoly can be approved.

While there are more things necessary, this is the infrastructure that created Ballad Health.

The story of Ballad Health, its creation, and the 2+ year protest against this state-created medical monopoly (which included citizens camped outside one of their hospitals 24/7 for 257 days straight) is a complex one. As you already know, it includes state laws, politicians, and business leaders. It also includes hospital bonds, the SEC, high-powered law firms, and private investigators.

It’s the stuff of Erin Brockovich really… I mean, if Erin Brockovich was in northeast Tennessee and southwest Virginia just prior to a global pandemic in a hostile political climate that keeps everyone from truly paying attention.

The long and short of it is that the region now has less access to healthcare, increased costs in many ways, and yet, this entire medical monopoly was created with the promise to be a “public advantage”.

Over the weeks to come, I will share more details about my first-hand knowledge and experience with Ballad Health, state lawmakers, the TN Department of Health, Kingsport City officials, and more.

For full disclosure, I am biased.

My granddaughter was born at Holston Valley Medical Center at just 26 weeks and weighing little more than one pound. The staff who cared for her reached out to me in October 2018 upon hearing that Ballad Health, this new medical monopoly, planned to close the neonatal intensive care unit that saved her life.

They asked for my help.

I gave them everything I had.

Now, I have a little more to give.

So, I’m back at it… trying everything I can think of to bring awareness to what happened to healthcare and what it has cost the people of this region.

Stay tuned… and thank you for reading.

Dani

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Dani Cook

Dani Cook is an independent web journalist, life coach, and advocate. Her passions include racial equity, healthcare, and social justice.