It’s time this country wakes up.

[Noyac]

Analysis: How Your Beloved Hospital Helps To Drive Up Health Care Costs - KFF Health News

It’s easy to criticize pharmaceutical and insurance companies. But we spend much more on hospitals.

khn.org

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[deleted941485]

Wake up to what? Health systems charge lots of money especially when you are an inpatient and the data bear that out. That’s a neat trick show us another one.

 

[Hoya11]

Analysis: How Your Beloved Hospital Helps To Drive Up Health Care Costs - KFF Health News

It’s easy to criticize pharmaceutical and insurance companies. But we spend much more on hospitals.

khn.org

Many hospitals are closing. The funds they receive from the government are not enough. They do this to stay in the black and despite doing this still survive on a pretty narrow margin.

Think about a community hospital paying for the overhead of the MRI machine, the CT machine, the overnight staff, the sick and non-paying patients, lots of other things.

Think about the ASCs taking away the paying patients from the hospitals leaving them with the dregs.

Whereas, pharmaceutical companies and insurance companies have multiple people making multimillion dollar salaries essentially skimming off the system. I don't see many pharmaceutical companies struggling to survive. And I don't see them providing such a needed service to the community.

Sure there are things about the hospital/CEOs/Chairman that are wasteful and part of the problem. But to me they are the lesser offender and often I feel bad for the position that they are in. Given, I am in a state with a lot of financial problems and people moving out

 

[martvubo]

Many hospitals are closing. The funds they receive from the government are not enough. They do this to stay in the black and despite doing this still survive on a pretty narrow margin.

Think about a community hospital paying for the overhead of the MRI machine, the CT machine, the overnight staff, the sick and non-paying patients, lots of other things.

Think about the ASCs taking away the paying patients from the hospitals leaving them with the dregs.

Whereas, pharmaceutical companies and insurance companies have multiple people making multimillion dollar salaries essentially skimming off the system. I don't see many pharmaceutical companies struggling to survive. And I don't see them providing such a needed service to the community.

Sure there are things about the hospital/CEOs/Chairman that are wasteful and part of the problem. But to me they are the lesser offender and often I feel bad for the position that they are in. Given, I am in a state with a lot of financial problems and people moving out

Medicolegally, at any point does it become justifiable to offer treatments that are below standard of care (e.g. CT instead of MRI, or older meds that have had enantiomers purified so the new drug is more expensive but supposedly strictly better) with the reasoning that the harm from the prohibitively high cost is worse than the harm of not getting the new drug or the best testing?

 

[WholeLottaGame7]

Medicolegally, at any point does it become justifiable to offer treatments that are below standard of care (e.g. CT instead of MRI, or older meds that have had enantiomers purified so the new drug is more expensive but supposedly strictly better) with the reasoning that the harm from the prohibitively high cost is worse than the harm of not getting the new drug or the best testing?

The bar for standard of care is typically fairly low. If you're talking expensive scans or fancy new drugs, those things are not typically standard of care. Think about all the people still on warfarin with all the new oral anticoagulants out there.

Also, standard of care is region specific and not universal. If you're pregnant and have a massive peripartum PE in the hallways of Ivory Tower University, your care is going to be different than having it in the middle of BFE.

The more interesting question is, how much should we let patients help decide the cost/benefit if there are choices available...

 

[Noyac]

Many hospitals are closing. The funds they receive from the government are not enough. They do this to stay in the black and despite doing this still survive on a pretty narrow margin.

Think about a community hospital paying for the overhead of the MRI machine, the CT machine, the overnight staff, the sick and non-paying patients, lots of other things.

Think about the ASCs taking away the paying patients from the hospitals leaving them with the dregs.

Whereas, pharmaceutical companies and insurance companies have multiple people making multimillion dollar salaries essentially skimming off the system. I don't see many pharmaceutical companies struggling to survive. And I don't see them providing such a needed service to the community.

Sure there are things about the hospital/CEOs/Chairman that are wasteful and part of the problem. But to me they are the lesser offender and often I feel bad for the position that they are in. Given, I am in a state with a lot of financial problems and people moving out

“Data shows that hospitals are by far the biggest cost in our $3.5 trillion health care system, where spending is growing faster than the gross domestic product, inflation and wage growth. Spending on hospitals represents 44% of personal expenses for the privately insured, according to the Rand Corp.

A report this year from researchers at Yale and other universities found that hospital prices increased a whopping 42% from 2007 to 2014 for inpatient care and 25% for outpatient care, compared with 18% and 6% for physicians”

My hospital is in the highest category.

 

[Hoya11]

“Data shows that hospitals are by far the biggest cost in our $3.5 trillion health care system, where spending is growing faster than the gross domestic product, inflation and wage growth. Spending on hospitals represents 44% of personal expenses for the privately insured, according to the Rand Corp.

A report this year from researchers at Yale and other universities found that hospital prices increased a whopping 42% from 2007 to 2014 for inpatient care and 25% for outpatient care, compared with 18% and 6% for physicians”

My hospital is in the highest category.

Sure its the biggest cost because its the place everyone goes when they are sick. Biggest cost doesn't mean most inefficient/biggest rip off. My biggest cost is my mortgage, but I'm most concerned about the money that I waste on going out to eat, etc.. There is only so much you can trim in a hospital. The other culprits are MORE guilty IMO

 

[ucladoc2b]

Sure its the biggest cost because its the place everyone goes when they are sick. Biggest cost doesn't mean most inefficient/biggest rip off. My biggest cost is my mortgage, but I'm most concerned about the money that I waste on going out to eat, etc.. There is only so much you can trim in a hospital. The other culprits are MORE guilty IMO

There are plenty of hospitals that make millions/billions in operating surpluses. There is a trend of huge consolidation in the industry with a resultant increase in prices. Sure, not all of them make tons of money. But hospitals for sure have strong lobby, high political support, lots of capital spending, admins with high salaries, et cetera

 

[shepardsun]

Anyone interested in American healthcare economics should read "An American Sickness" by Elisabeth Rosenthal to see just how out of control medical spending is, predominantly for reasons already mentioned regarding the large hospital systems, many of which are non-profit in name only. And it would be one thing if the outcomes we saw for the costs were substantially better than they actually are. To @Hoya11's metaphor, that would be like paying a 500k mortgage for 300k worth of house simply because your contractor was under no obligation to be transparent in how their prices differed from their competitors.

 

[VA Hopeful Dr]

There are plenty of hospitals that make millions/billions in operating surpluses. There is a trend of huge consolidation in the industry with a resultant increase in prices. Sure, not all of them make tons of money. But hospitals for sure have strong lobby, high political support, lots of capital spending, admins with high salaries, et cetera

Raw numbers don't matter, what's their percent profit? Most are around 3-5% from what I've seen.

That's not exactly super greedy

 

[ucladoc2b]

Raw numbers don't matter, what's their percent profit? Most are around 3-5% from what I've seen.

That's not exactly super greedy

Most don’t release data, and when they do it’s often questionable.

HCA, one of the few companies that has to release 10K data makes about 10% pre tax. I’m sure some of the big non profits make even more.

 

[nimbus]

Raw numbers don't matter, what's their percent profit? Most are around 3-5% from what I've seen.

That's not exactly super greedy

Even those numbers can easily be manipulated. Revenues up this year? Buy another robot or build a new cancer center. Match the expenses to revenues to get whatever target profit margin you want or zero it out if you are not for profit.

 

[VA Hopeful Dr]

Even those numbers can easily be manipulated. Revenues up this year? Buy another robot or build a new cancer center. Match the expenses to revenues to get whatever target profit margin you want or zero it out if you are not for profit.

Yes, but kinda no. For public hospitals it's pretty easy to get the actual numbers. Nonprofits, which are most of the rest, are a little harder but can still be found.

 

[dhb]

Even those numbers can easily be manipulated. Revenues up this year? Buy another robot or build a new cancer center. Match the expenses to revenues to get whatever target profit margin you want or zero it out if you are not for profit.

Over here a lot of ASCs don't "make money" but suprize, they pay very high rents for the building to the parent company that owns it.
Lots of tricks and loopholes don't reflect in the data that is published.