It Doesn’t Cost What It Costs
A candidate for the list of most ridiculous quotes:
“When considering the cost of health care, what matters most to consumers is the actual amount paid for their care, not the hospital’s charges.”
This ludicrous statement was made, according to the New York Times, by Sara Virgin, a spokeswoman for Wuesthoff Health System, one of the many hospital systems whose charges have jumped 25% or more since last year. No, Sara, actually what matters most to consumers is how much they have to pay for their care, and in your system they pay a heck of a lot more than they did last year.
According to the NYT (http://www.nytimes.com/2014/06/03/business/Medicare-Hospital-Billing-Data-Is-Released.html?hp&_r=0), charges for some of the most common inpatient conditions and procedures have jumped significantly in the past year. If you get admitted for chest pain, for example, the average cost is $18,000, up from $16,000. At Wuesthoff Medical Center in Florida, if you were admitted last year with a “severe heart arrhythmia” the charge was $25,000. Now it’s $53,000. This does not sound like controlling health care costs, does it? Various hospital administration officials and “experts” have weighed in on why this is happening. Here are some of them:
1. The number of hospital admissions has gone down. Hospitals have been encouraged to manage diseases as outpatients if possible. According to the website Modern Healthcare: “The trends are likely to continue, say analysts and hospital executives, because of the slow U.S. economic rebound; the continued rise of high-deductible insurance plans that constrain medical use; the growth in the number of patients who are held for observation instead of being admitted; and the reforms of payment and delivery models to better coordinate care, improve outcomes and lower costs. The drop in admissions is also related to the U.S. healthcare system’s success stories, such as treating heart patients effectively without hospitalization.” Medicare doesn’t pay asking price, so the price goes up for everyone else.
2. Technology and Drug prices. Right. Because every hospital needs two DaVinci robots and a full stock of Pradaxa.
3. Mergers. For example, Wuesthoff Health System, the Florida hospital I mentioned above, traces its roots back to 1941 when it opened a community hospital. Wuesthoff was acquired in 2010 by the for-profit hospital giant Health Management Associates, which in turn was recently bought by Community Health Systems. I’m no MBA but these kind of mergers tend to reduce competition and raise prices.
4. Electronic Medical Records, etc. At my hospital about 10 years ago, implementation of an EMR in Anesthesia department necessitated the permanent hiring of at least three full-time computer experts. Multiply this times all the departments in all the hospitals, and you’ve got pretty heft admin. costs for something that’s supposed to decrease health care spending. Add in the cost of hiring and training a bunch of new coders for ICD-10 and you’re really in the proverbial soup.
5. Lack of accountability. Here’s what the NYT reporters got when they tried to ask one of the hospitals they cite for comment: “…a spokeswoman for Baptist [Baptist Medical Center, San Antonio] said the hospital didn’t have the time to analyze the data itself.” Oh. But… It’s your data. Anyone who’s ever been audited by the IRS knows that if you don’t interpret your own data, someone will do it for you, and you won’t like the conclusions they draw.
Notice that virtually none of these reasons has anything to do with the care of actual real-live patients. Us evil, greedy doctors in the trenches of patient care can’t be blamed for these prices changes, although I’m sure people will try. No, for this data you have to blame good old Capitalism. That’s the system we wanted, remember?