Hospital administrators pillaging healthcare

[Haybrant]

Wondering why that stitch in the ED costs more than $500. This is why:

"$584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator...In a deal that is not unusual in the industry, Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million, the bulk of it from stocks vested and options he exercised that year. Likewise, Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million."

http://www.nytimes.com/2014/05/18/s...re-not-the-big-cost.html?hp&rref=opinion&_r=0

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[Brain Bucket]

This is a job for PETI.

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[Anastomoses]

This is a job for PETI.

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Didn't we agree that's an awful name? Awful.

 

[Brain Bucket]

Didn't we agree that's an awful name? Awful.

I thought it was quite clever.

 

[tabsviewshope]

i think so,I thought it was quite clever.thank you

 

[WhippleWhileWeWork]

i think so,I thought it was quite clever.thank you

Robot?

Some pre-med trying to take credit for my acronym? I'll cut you.

 

[croak]

Wondering why that stitch in the ED costs more than $500. This is why:

"$584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator...In a deal that is not unusual in the industry, Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million, the bulk of it from stocks vested and options he exercised that year. Likewise, Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million."

http://www.nytimes.com/2014/05/18/s...re-not-the-big-cost.html?hp&rref=opinion&_r=0

Thank the Affordable Care Act.

 

[NontradCA]

Thank the Affordable Care Act.

huh? You can thank capitalism, and capitalism alone.

 

[NontradCA]

I think this article is stupid. Physicians are always crying about class warfare, but this is exactly what they are doing by attacking administrators. Sure, most of the general public will eat this up, but I wouldn't count on them taking sides with physicians.

 

[Roxas]

huh? You can thank capitalism, and capitalism alone.

I'm genuinely curious, what do you propose instead?

 

[Psai]

I think this article is stupid. Physicians are always crying about class warfare, but this is exactly what they are doing by attacking administrators. Sure, most of the general public will eat this up, but I wouldn't count on them taking sides with physicians.

It's not class warfare to say that administrators are wasting our time with their stupid metrics and micromanagement while taking a large portion of the revenue that our work generates.

 

[NontradCA]

It's not class warfare to say that administrators are wasting our time with their stupid metrics and micromanagement while taking a large portion of the revenue that our work generates.

Because administrators are completely useless? Look at the headline of the article. It's propaganda similar to what you would see for NP independent practice rights.

 

[NontradCA]

I'm genuinely curious, what do you propose instead?

It will sort itself out once the costs become too great. Hopefully.

 

[Roxas]

It will sort itself out once the costs become too great. Hopefully.

So are you pro ACA?

 

[NontradCA]

So are you pro ACA?

No. The ACA did not really change anything, except to make everyone have mandatory insurance. All the cuts, expansion etc. would have came regardless of it.

 

[WhippleWhileWeWork]

I think this article is stupid. Physicians are always crying about class warfare, but this is exactly what they are doing by attacking administrators. Sure, most of the general public will eat this up, but I wouldn't count on them taking sides with physicians.

Do you think Physicians are over paid?

 

[NontradCA]

Do you think Physicians are over paid?

No, not at all. I think they're underpaid. I also think PHDs are underpaid as well, so take that as you will. The economy does not respect labor, and that's essentially what doctors are.

 

[WhippleWhileWeWork]

No, not at all. I think they're underpaid.

Then why wouldn't you expect them to defend themselves against attacks of being over paid and their income being the main cost in healthcare? They aren't, and it's not. Shinning light on where the money is going isn't necessary class warfare.

 

[NontradCA]

Then why wouldn't you expect them to defend themselves against attacks of being over paid and their income being the main cost in healthcare? They aren't, and it's not. Shinning light on where the money is going isn't necessary class warfare.

It is class warfare, when it is insinuating that the people above them are overpaid and should be paid less - and with no change to the system? Lol. That's the definition of class warfare.

 

[Psai]

Because administrators are completely useless? Look at the headline of the article. It's propaganda similar to what you would see for NP independent practice rights.

They're worse than useless, their effects are detrimental to patient care. When's the last time you heard a doctor say that they needed more checklists and patient satisfaction score results to help them take care of patients?

 

[WhippleWhileWeWork]

It is class warfare, when it is insinuating that the people above them are overpaid and should be paid less - and with no change to the system? Lol. That's the definition of class warfare.

Did you even bother reading the article?

"Doctors are beginning to push back: Last month, 75 doctors in northern Wisconsin took out an advertisement in The Wisconsin State Journal demanding widespread health reforms to lower prices, including penalizing hospitals for overbuilding and requiring that 95 percent of insurance premiums be used on medical care. "

"Lol"

 

[NontradCA]

They're worse than useless, their effects are detrimental to patient care.

Specifically?

 

[NontradCA]

"Lol", "no change to the system?"

Did you even bother reading the article?

"Doctors are beginning to push back: Last month, 75 doctors in northern Wisconsin took out an advertisement in The Wisconsin State Journal demanding widespread health reforms to lower prices, including penalizing hospitals for overbuilding and requiring that 95 percent of insurance premiums be used on medical care. "

"Lol"

Yea and that's ridiculous. The biggest profit makers in the industry are Pharmaceuticals and medical devices. Hospital stays and prices are reflective of that. Hospitals do not control costs.

 

[WhippleWhileWeWork]

Yea and that's ridiculous. The biggest profit makers in the industry are Pharmaceuticals and medical devices. Hospital stays and prices are reflective of that.

You seem to be moving the goal post. First you say it's class warfare because there was no changing of the system mentioned, except there was. So your argument was bogus, by your own definition. Now, given the push for a change mentioned, it's "ridiculous" because...it doesn't go far enough? Am I following, it's a little hard to track?

 

[NontradCA]

You seem to be moving the goal post. First you say it's class warfare because there was no changing of the system mentioned, except there was. So your argument was bogus, by your own definition. Now, given the push for a change mentioned, it's "ridiculous" because...it doesn't go far enough? Am I following, it's a little hard to track?

Demanding hospitals take a pay cut is not changing the system. I'm not moving the goal post, your example is stupid. I'm not going to play semantics with you, so have a good day.

 

[WhippleWhileWeWork]

Demanding hospitals take a pay cut is not changing the system. I'm not moving the goal post, your example is stupid.

If that's not a change to the system, then please enlighten us to YOUR definition of a change.

 

[NontradCA]

I'm not going to play semantics with you, so have a good day.

 

[WhippleWhileWeWork]

Yea and that's ridiculous. The biggest profit makers in the industry are Pharmaceuticals and medical devices. Hospital stays and prices are reflective of that. Hospitals do not control costs.

Who do you think bills for the salary, stock options, and retirement plans for the administrators? Who do you think pays for that?

 

[Anastomoses]

I thought it was quite clever.

the acronym is gorgeous; the name, itself - not so much.

Some pre-med trying to take credit for my acronym? I'll cut you.

with a scalpel!

 

[Brain Bucket]

the acronym is gorgeous; the name, itself - not so much.

with a scalpel!

Really? I think the double entendre is delicious. Plausible deniability. The whole thing is a work of art.

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[WhippleWhileWeWork]

Really? I think the double entendre is delicious. Plausible deniability. The whole thing is a work of art.

Sent from my SM-N9005 using Tapatalk

I'd blush but I had an endoscopic thoracic sympathectomy.

 

[TXKnight]

OK, suits get paid a whole lot and may be construed as wasteful. The problem I have with this article is that it sounds exactly the same as the doctor-bashing NP propaganda the NYT likes to publish.

 

[WhippleWhileWeWork]

OK, suits get paid a whole lot and may be construed as wasteful. The problem I have with this article is that it sounds exactly the same as the doctor-bashing NP propaganda the NYT likes to publish.

I think the difference is that this one tried to at least present the full spectrum of salaries from bottom to top instead of cherry picking to further the agenda. My guess is that the author would like to see all salaries in healthcare reduced, though so it's certainly not a "this one is on our side" situation.

 

[DocVapor]

OK, suits get paid a whole lot and may be construed as wasteful. The problem I have with this article is that it sounds exactly the same as the doctor-bashing NP propaganda the NYT likes to publish.

It does at first glance. But physicians and nurses all directly produce results with of patient outcomes. Most suits do not, but leech huge salaries anyway. A certain number of suits are absolutely needed to make sure the hospital runs smoothly, but the numbers of administrators today is way overblown. I don't mind attacking jobs that are useless.

 

[NontradCA]

It does at first glance. But physicians and nurses all directly produce results with of patient outcomes. Most suits do not, but leech huge salaries anyway. A certain number of suits are absolutely needed to make sure the hospital runs smoothly, but the numbers of administrators today is way overblown. I don't mind attacking jobs that are useless.

You don't see this as the same as what NPs are trying to do? Physicians are doing a terrible job at proving their worth to the public. Do you honestly believe that attacking hospital administrators is going to bode well? The general public views the medical system as a business and not in their best interest. They couldn't care less about its inner bickering. It just makes it easier for it to be struck down as a whole.

 

[DocVapor]

You don't see this as the same as what NPs are trying to do? Physicians are doing a terrible job at proving their worth to the public. Do you honestly believe that attacking hospital administrators is going to bode well? The general public views the medical system as a business and not in their best interest. They couldn't care less about its inner bickering. It just makes it easier for it to be struck down as a whole.

Its similar, yes. But nurses are saying they can do our job just as well as we can. I would say that we need to attack the administrators because they dictate how we do our jobs without any medical training (unless it is a physician that has transitioned to admin job of course), and we want them gone so that we can focus on our patients instead of appeasing the suits.

Would John Q. Public be able to understand the nuance? Some would. Plenty of others would willfully ignore it to bring us all down.

 

[NontradCA]

Its similar, yes. But nurses are saying they can do our job just as well as we can. I would say that we need to attack the administrators because they dictate how we do our jobs without any medical training (unless it is a physician that has transitioned to admin job of course), and we want them gone so that we can focus on our patients instead of appeasing the suits.

Would John Q. Public be able to understand the nuance? Some would. Plenty of others would willfully ignore it to bring us all down.

But someone needs to run the business side of things. The system is there to make money, and there are people who; much more savvy than physicians, have cashed in and control it. Physicians may see themselves as the most integral piece, but the general public does not. Think about how often physicians are sued, complain about not affecting the outcomes of patients, and at the same time oppose free access to all. The public is aware of all of this. The call to take away administrators is too little, too late.

The golden age of physicians is over. Physicians lost a long time ago. The best you can hope for is a single payer system. But what we will get is a two tiered system and indentured servitude.

 

[DocVapor]

But someone needs to run the business side of things. The system is there to make money, and there are people who; much more savvy than physicians, have cashed in and control it. Physicians may see themselves as the most integral piece, but the general public does not. Think about how often physicians are sued, complain about not affecting the outcomes of patients, and at the same time oppose free access to all. The public is aware of all of this. The call to take away administrators is too little, too late.

The golden age of physicians is over. Physicians lost a long time ago. The best you can hope for is a single payer system. But what we will get is a two tiered system and indentured servitude.

Well I am not really ready to throw in the towel before I even get my first resident's paycheck. And educating the public (or attempting to, at least) about our role will always be useful, especially if we go to single payer.

 

[NontradCA]

Well I am not really ready to throw in the towel before I even get my first resident's paycheck. And educating the public (or attempting to, at least) about our role will always be useful, especially if we go to single payer.

Well, if you don't want to throw in the towel then you should be working with the people who control healthcare now to cut costs and have better care, not throwing them under the bus. Otherwise, here comes Uncle Sam to clean up the mess.

 

[KinasePro]

But someone needs to run the business side of things. The system is there to make money, and there are people who; much more savvy than physicians, have cashed in and control it. Physicians may see themselves as the most integral piece, but the general public does not. Think about how often physicians are sued, complain about not affecting the outcomes of patients, and at the same time oppose free access to all. The public is aware of all of this. The call to take away administrators is too little, too late.

The problem with the situation is that honestly, everyone's role and salary is somewhat justified in the current healthcare environment.

Pharma and medical devices? Sure, they have more political clout, but they also bear a similar amount of risk for their endeavors as physicians do. Those of you who have worked in those industries realize how much failure is required for a single market success. If we force cuts to pharma/medical device prices, there's 100% guarantee that innovation in those areas will no longer occur in the US. There's not much wiggle room for their costs, either. Pharma is already off-shoring like crazy, and theres a very high likelihood that tomorrow's medicines will be discovered in europe/india/china as it is.

Administrators are so costly its absurd, but again they have an important role in the system. Cut those CEO's and upper-level admin salaries and they will happily make a lateral move to a better market/industry, and we'll be left with even worse administrators.

There is no simple fix or easy finger to point in this situation unfortunately.

All that being said, if any fat needs to be trimmed, I believe any reasonable person will agree that it needs to occur on the administrative side instead of the providers or innovators (pharma, devices, etc..). As the docs in Wisconsin and Kansas (from an earlier story) have demonstrated, the system can deliver with much less administrative overhead.

It's not a simple as "now we're just pointing the finger at administrators, we're no better!" Administrative cuts are a valid solution to the problem, but it's an incredibly disruptive solution to the problem that will not come easily by any means. But the lesser of all the evils? Probably.

The best you can hope for is a single payer system. But what we will get is a two tiered system and indentured servitude.

I hate to be a broken record, but look how single payer has worked out for the VA system. Single payer is an awful solution to this problem and won't happen in our lifetime, thankfully.

 

[DocVapor]

Well, if you don't want to throw in the towel then you should be working with the people who control healthcare now to cut costs and have better care, not throwing them under the bus. Otherwise, here comes Uncle Sam to clean up the mess.

I would love to work with them once I have the gravitas necessary. But something tells me they won't come to the table with honest intentions. They know (and the AANA, and jounalists) that at some point, the nice guy loses.

 

[fancymylotus]

blame obama

 

[TXKnight]

....
I hate to be a broken record, but look how single payer has worked out for the VA system. Single payer is an awful solution to this problem and won't happen in our lifetime, thankfully.

Genuinely curious why you are so certain

 

[NontradCA]

The problem with the situation is that honestly, everyone's role and salary is somewhat justified in the current healthcare environment.

Pharma and medical devices? Sure, they have more political clout, but they also bear a similar amount of risk for their endeavors as physicians do. Those of you who have worked in those industries realize how much failure is required for a single market success. If we force cuts to pharma/medical device prices, there's 100% guarantee that innovation in those areas will no longer occur in the US. There's not much wiggle room for their costs, either. Pharma is already off-shoring like crazy, and theres a very high likelihood that tomorrow's medicines will be discovered in europe/india/china as it is.

Administrators are so costly its absurd, but again they have an important role in the system. Cut those CEO's and upper-level admin salaries and they will happily make a lateral move to a better market/industry, and we'll be left with even worse administrators.

There is no simple fix or easy finger to point in this situation unfortunately.

All that being said, if any fat needs to be trimmed, I believe any reasonable person will agree that it needs to occur on the administrative side instead of the providers or innovators (pharma, devices, etc..). As the docs in Wisconsin and Kansas (from an earlier story) have demonstrated, the system can deliver with much less administrative overhead.

It's not a simple as "now we're just pointing the finger at administrators, we're no better!" Administrative cuts are a valid solution to the problem, but it's an incredibly disruptive solution to the problem that will not come easily by any means. But the lesser of all the evils? Probably.



I hate to be a broken record, but look how single payer has worked out for the VA system. Single payer is an awful solution to this problem and won't happen in our lifetime, thankfully.

Are you joking? Cutting administrative salary does little. Their bonuses are generated off how much profit the hospital gains, sure, but it's more likely due to volume and efficiency as it is ripping off sick people. When people talk about cost in medical care, it's not salaries- those are the people working in it. Their pay is justified like you said, and you're forgetting that it's a fraction of the total healthcare budget. The cost comes from several factors including:

-Pharmaceuticals and devices setting the market
-The ridiculous medical model of treating chronic disease at all stages of life (this is the biggest one mind you)
-With the above, 1 in 2 adults in the US have some sort of chronic health problem

These problems are societal and nothing to really do with administrators or physicians/NPs/PAs/RNs/MAs. These are workers that deliver a commodity they can not control. Unless you can figure out a way to properly manage chronic disease or *gasp*, prevent it and have people die at home rather than a outrageous ICU stay, then you can fix the budget issue. However, there's too many factors that go into taking control of those problems, and I don't think everyone is on the same page as to how they should be solved. I'm also curious as to why you think single payer is unlikely. Nearly everyone can agree that the current model is unsustainable, so what would come next?

I agree with you on the VA. Let's take a look at why though. What's the difference between active/retired healthcare at MTFs (successful single payer), and the VA?

 

[Anastomoses]

I'm tired of all this talking in circles. Can someone just post real stats + graphs? And comparative graphs of what the proposed changes would affect and how that would solve issues?

 

[fancymylotus]

I'm tired of all this talking in circles. Can someone just post real stats + graphs? And comparative graphs of what the proposed changes would affect and how that would solve issues?

Circle graphs?

 

[DocVapor]

These problems are societal

Truth.

 

[WhippleWhileWeWork]

I'm tired of all this talking in circles. Can someone just post real stats + graphs? And comparative graphs of what the proposed changes would affect and how that would solve issues?

This should do it.

 

[WhippleWhileWeWork]

Even more telling:

 

[Brain Bucket]

And what if the NPs take it and start calling us PETTY?

Lol. That's the point. I thought it was understood. It's obviously not practical, but it's beautiful nonetheless.

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