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Guest Post: How Hospitals Profit From Making Mistakes

Tyler Durden's picture




 

Submitted by Michael Krieger of Liberty Blitzkrieg blog,

One of the many things holding the nation back at the moment is the complete lack of incentive to be a creative, productive and honest member of society versus the tremendous incentive to be a corrupt, thieving, lackey for the establishment.  In a free market system, with a strict set of rules governing the game that is applied to everyone equally, market signals and incentives exist for companies to create a great product and to meet customer needs with great service.  In contrast, within a crony capitalist system, the primary incentive is to get as close as possible to political and corporate power in order to financially benefit from their oligarchical ownership of the controlled economy.

It is only within a completely disconnected from reality, crony, fraudulent economy where you could have a situation in which hospitals actually earn much larger profit margins from making mistakes and harming their patients, than from providing excellent care.  We learn from the New York Times that:

Hospitals make money from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented, a new study finds.

 

Changing the payment system, to stop rewarding poor care, may help to bring down surgical complication rates, the researchers say. If the system does not change, hospitals have little incentive to improve: in fact, some will wind up losing money if they take better care of patients.

 

The study and an editorial were published Tuesday in The Journal of the American Medical Association. The study authors are from the Boston Consulting Group, Harvard’s schools of medicine and public health, and Texas Health Resources, a large nonprofit hospital system.

 

The study is based on a detailed analysis of the records of 34,256 people who had surgery in 2010 at one of 12 hospitals run by Texas Health Resources. Of those patients, 1,820 had one or more complications that could have been prevented, like blood clots, pneumonia or infected incisions.

 

The median length of stay for those patients quadrupled to 14 days, and hospital revenue averaged $30,500 more than for patients without complications ($49,400 versus $18,900). Private insurers paid far more for complications than did Medicare or Medicaid, or patients who paid out of pocket.

 

The authors said in an interview that they were not suggesting that hospitals were trying to make money by deliberately causing complications or refusing to address the problem.

 

“Absolutely not,” said David Sadoff, a managing director of the Boston Consulting Group. “We don’t believe that is happening at all.”

 

But, he said, the current payment system makes it difficult for hospitals to perform better because improvements can wind up costing them money.

 

Dr. Barry Rosenberg, an author and a managing director of Boston Consulting, said the study came about because his firm was working with Texas Health Resources to find ways to reduce its hospitals’ surgical complication rates, which, at 5.3 percent, were in line with those reported by similar hospitals. Part of that work involved analyzing the costs, and he said the team was stunned to realize that lowering the complication rates would actually cost the hospital money.

 

“We said, ‘Whoa, we’re working our tails off trying to lower complications, and the prize we’re going to get is a reduction in profits,’ ” Dr. Rosenberg said in an interview.

If the above tale does not demonstrate how completely screwed up our economy and society is, I don’t know what will.  Even if we assume every single person in a given hospital is a completely moral, decent human being who would never purposely prolong a patient’s stay, the mere fact that investing in improvements in the hospital and providing better care could lead to a dramatic decline in profit margins is a total tradegy.  What do you think we are going to end up with if we have these kinds of incentives?

Full article here.

 

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Sun, 04/21/2013 - 20:14 | 3481815 Yen Cross
Yen Cross's picture

 Hospitals are "Death Wards" for the uninsured.  Don't get sick Bitchez/

Sun, 04/21/2013 - 20:38 | 3481870 Manthong
Manthong's picture

The free man's theraputive alternative that will screw the system..

Try to stay healthy, but if you cannot..

CRAWL IN A HOLE AND DIE.

like every other animal.

 

 

..if you are red, you are not free.

 

Sun, 04/21/2013 - 20:48 | 3481924 LetThemEatRand
LetThemEatRand's picture

And yet the public is almost universally convinced that the problem is lawsuits, e.g., private parties seeking redress for wrongs that lead to the higher costs that profit the hospitals.  Let's get rid of that mechanism for private redress through the Courts so our well-meaning health care system can have no accountability at all.  To anyone.

Sun, 04/21/2013 - 20:50 | 3481947 Manthong
Manthong's picture

the system is the problem, not the solution.

Sun, 04/21/2013 - 20:54 | 3481967 LetThemEatRand
LetThemEatRand's picture

The health care system will exist in one form or another regardless of the political system.  And it will continue to benefit from its own mistakes (higher cost to patients = higher profit) unless there is a check and balance.  It's not like you can negotiate the cost of emergency surgery -- the remedy is after you've been screwed.  The insurance industry and American Medical Association are powerful entities who have convinced the public to reduce their accountability.

Sun, 04/21/2013 - 21:02 | 3482008 Manthong
Manthong's picture

where was the AMA in May of 1790?

Sun, 04/21/2013 - 21:05 | 3482017 LetThemEatRand
LetThemEatRand's picture

In 1790, doctors used saws and leaches and thought infection was caused by humors.  The AMA is a private entity.

Sun, 04/21/2013 - 21:10 | 3482029 Manthong
Manthong's picture

The AMA and the WHO owns you.

Obamacare owns you.

You and your children are slaves unless you lose your fear.

This cannot be argued.

Sun, 04/21/2013 - 21:14 | 3482054 LetThemEatRand
LetThemEatRand's picture

We all get sick and we all need medical care (maybe a very few get lucky and just die in their sleep after never seeing a doctor or needing surgery, but the vast majority are not so fortunate).  Most people can't pay six figures for a simple operation or a new knee or cancer treatment etc, yet the medical system as it has evolved with private insurance and private pay demands that.  What do you propose if the People can't get together and pay into a fund to pay for care for themselves when they need it?

Sun, 04/21/2013 - 21:19 | 3482077 Manthong
Manthong's picture

geez LTER.. can't you see?

it is not up to the system to take care of us..

it is up to us individually and collectively through love, charity and dignity... but not through the coercion of a system run by self interested villians and ignorant tools.

 

Sun, 04/21/2013 - 21:35 | 3482131 LetThemEatRand
LetThemEatRand's picture

I don't like to rely on charity.   There are a few charitable doctors, but most want cold hard cash when you need an MRI.   I prefer to have a choice to band together with my fellow mortal humans and fund healthcare as needed, kind of like car insurance.

Sun, 04/21/2013 - 21:49 | 3482181 Manthong
Manthong's picture

.gosh.. I don't want you to have to pay for me and I don't want to have to pay for you.

I think that has something to do with freedom. 

but I would be pleased to share some of my excess to help your family..

Sun, 04/21/2013 - 21:51 | 3482214 LetThemEatRand
LetThemEatRand's picture

There is a difference (we all pay taxes for things like roads and satellites and defense and airports), but it seems to me like the real issue is -- what is the alternative.  You proposed charity.  Which hospital will give me a free MRI and knee replacement again?  There are several hundred million people in the U.S. and the VAST majority cannot afford to pay for a simple procedure out of pocket.    What do you say when their kids need an expensive operation that will save their lives and no Bill Gates shows up with a checkbook?

Sun, 04/21/2013 - 22:05 | 3482244 Manthong
Manthong's picture

aw.. focus for a moment your savings..

the system is rigged to deny you rental value for your money.. 

the system is rigged to steal your medical " insurance investment" as well.

there is no insurance as the counterparties are demonstrated thieves

you are the only guarantor of your life and security.

maybe you will find some friends to trust

but they likely will not be in government.

 oh.. and there is no free lunch or free knee.

 

Sun, 04/21/2013 - 22:12 | 3482265 LetThemEatRand
LetThemEatRand's picture

That's great ideologue stuff, but the reality is that most people could save 50% of their income for 20 years and it would be wiped out by a one week hospital stay, which typically runs six figures.  You have no solution to that other than more platitudes I suppose.  

Sun, 04/21/2013 - 22:25 | 3482333 Manthong
Manthong's picture

platitudes.. hmm,, like Socrates, Plato, Aristotle, Bastiate, Locke, DeToqueville, Jefferson, Mises, Hayek et al..

I suppose so,

Sun, 04/21/2013 - 22:55 | 3482427 LetThemEatRand
LetThemEatRand's picture

There you go again.

Mon, 04/22/2013 - 01:24 | 3482677 Unique Snowflake
Unique Snowflake's picture

If the govt didn't tax the fuck out of everyone to pay for it's bullshit corrupt promises, people could live, save and be prepared for medical costs. The problem IS govt and fractional reserve infinite debt growth. Without these, people would be far more productive, responsible and when needed, even charitable.

 

Speaking of leeches...

Mon, 04/22/2013 - 01:36 | 3482681 LetThemEatRand
LetThemEatRand's picture

Bullshit.  If the average person saved 50% of their income (more than is taxed) for 20 yearshttp://www.mybudget360.com/how-much-does-the-average-american-make-break... , it would not pay for their child's cancer therapy ($500K)http://usatoday30.usatoday.com/money/industries/health/2005-08-31-health...

Mon, 04/22/2013 - 04:08 | 3482864 Harlequin001
Harlequin001's picture

That's because the cost of medical services is far too high. If big pharma couldn't sell services to a provider that has no concern for market forces such as the govt then all these highly paid surgeons would be idle, until they reduced their fees to something that could be substantiated by the market and not a leveraged insurance policy. In which case I too would support lower taxes and pay my own medical bills.

It shouldn't cost 500K for a child's cancer therapy.

Not sure what you're arguing about here...

Mon, 04/22/2013 - 07:19 | 3482993 noless
noless's picture

Are you fucking trolling man? Your argument has it's basis in nominal cost in a system which is demonstrably broken and parasitical, have you worked in medical Billing? There is no fucking spoon..

Mon, 04/22/2013 - 10:22 | 3483599 InTheLandOfTheBlind
InTheLandOfTheBlind's picture

stop looking for him to actually be substantive in response.... it is all rhetoric... dealing with actual care will not happen here

Sun, 04/21/2013 - 23:52 | 3482447 FL_Conservative
FL_Conservative's picture

eom

Sun, 04/21/2013 - 22:44 | 3482307 Manthong
Manthong's picture

Lastly.. capitalism is supposed to be about capital accumulation..

The economic abortion we are in makes capital accumulation impossible for ordinary working folks through anything other than deceit, theft or blind luck.

The kids are screwed until we fix this.

Please look beyond the immediate facades of security and understand the dangers to freedom that are lurking to plunge us back into serfdom.

Mon, 04/22/2013 - 00:58 | 3482428 LetThemEatRand
LetThemEatRand's picture

Most of those dangers have taken over our Constitutional government of the People and call themselves capitalists.   And where is your solution to the practical problem of a 3 year old with cancer whose parents work part-time at some big company and therefore have no health insurance?

Mon, 04/22/2013 - 01:39 | 3482690 Manthong
Manthong's picture

dependent.. subservient..  hopeless..  pitiful,, ask your government for mercy

Mon, 04/22/2013 - 01:43 | 3482699 LetThemEatRand
LetThemEatRand's picture

Ideology, and no practical solutions.  Still.

Mon, 04/22/2013 - 01:54 | 3482723 Manthong
Manthong's picture

I did not understand the prevailing sentiment..

my apologies.

Accordingly, you should not ask or petition..

just go ahead and beg.

Mon, 04/22/2013 - 01:57 | 3482734 LetThemEatRand
LetThemEatRand's picture

Still waiting for your solution for the 3 year old with cancer.  

Mon, 04/22/2013 - 02:04 | 3482743 akak
akak's picture

What, have you been diagnosed with cancer?

It couldn't have happened to a more deserving person.

 

PS: I am guessing cancer of the brain?

Mon, 04/22/2013 - 02:10 | 3482754 LetThemEatRand
LetThemEatRand's picture

You have just summed up your ideology perfectly.

Mon, 04/22/2013 - 02:12 | 3482756 Manthong
Manthong's picture

Man,, I will send you fifty bucks.. but please don't steal it from me first.

Mon, 04/22/2013 - 02:16 | 3482763 LetThemEatRand
LetThemEatRand's picture

Okay, but don't drive on my road or use my hospital that I contributed to.  

Mon, 04/22/2013 - 02:19 | 3482770 Manthong
Manthong's picture

deal.

Mon, 04/22/2013 - 02:20 | 3482773 LetThemEatRand
LetThemEatRand's picture

He says until he needs to drive to the hospital.   Do you believe your own bullshit?

Mon, 04/22/2013 - 02:25 | 3482779 akak
akak's picture

Are you simply insane, or evil?

 

Mon, 04/22/2013 - 02:29 | 3482782 LetThemEatRand
LetThemEatRand's picture

Just not a complete narcissistic asshole like you, akak.  What would Rand say?  I'm sure I'll hear it soon.

Mon, 04/22/2013 - 02:36 | 3482785 Manthong
Manthong's picture

thanks.. that was fun   :-D

as God is my witness, I will crawl in a hole and die with horrid pain to F the model of the evil manipulators.

Mon, 04/22/2013 - 02:49 | 3482801 LetThemEatRand
LetThemEatRand's picture

No, like Rand you'll take public assistance when it is in your own interest. 

Mon, 04/22/2013 - 10:44 | 3483695 Gohn Galt
Gohn Galt's picture

Rand.  There are many that will not take or participate in public assistance.  It is not easy in the USA as everyone and everything is against this decision.  So it may seam.  On the otherside of dependence is true independence.  No government in history has really been for independence.  By its definition it must promote/support dependence or it will be the vehicle to its own demise. 

Besides, as you know, these hospital errors are not errors at all.  Government controls the playing field and rewards what it wants more of.  Votes and protesting are meaningless distractions for serfs, the only real voting is with your wallet or your feet.

Good comments Manthong.

Mon, 04/22/2013 - 09:44 | 3483438 Gohn Galt
Gohn Galt's picture

How about making it illegal to offer any other solution that is not approved by the kabal.  Of course the laws of the universe work differently in the US, so solutions that work outside of the US might not ever work inside the US.

Mon, 04/22/2013 - 01:55 | 3482732 Hobbleknee
Hobbleknee's picture

Chemo therapy wouldn't cost $30K a pop if it weren't for the current system of using insurance to pay for everything, which was also brought about by government meddling. There is alos charity, which would also increase if taxes decreased.  Also,

Mon, 04/22/2013 - 02:01 | 3482735 LetThemEatRand
LetThemEatRand's picture

It costs $250K to go to medical school.   The ABA (a private entity) restricts entry.

Mon, 04/22/2013 - 07:29 | 3483024 Hobbleknee
Hobbleknee's picture

I think you mean AMA, but yes, there are many reasons for the outrageous prices, all of which have nothing to do with the mythical "free market" or its absent brother Capitalism, and everything to do with government intervention and cartels, like the AMA.

I actually tried to edit my comment with more info this morning, but I kept getting a strange error.

Mon, 04/22/2013 - 02:13 | 3482759 StychoKiller
StychoKiller's picture

Like anything else the Govt subsidizes, the subsidized will grow larger; in this instance, the Govt is subsidizing sick people.  Tell us once more how Big Brother is gonna ride to the rescue (again!)

Mon, 04/22/2013 - 10:04 | 3483534 Rusty_Shackleford
Rusty_Shackleford's picture

"I don't like to rely on charity."

 

 

"...but pointing guns at people and demanding they pay for my consumption is just fine."

 

Right?

Mon, 04/22/2013 - 09:14 | 3483321 Mr. Magniloquent
Mr. Magniloquent's picture

Private insurance pools did exist, but are largely the creation of Congress and FDR's buereaucracy. The expense of medicine has far more to do with AMA's monopoly on medicine, and the deliberate barriers to entry within the field. Prohibitive, and often innane regulations form the third angle of the "iron triangle". I was a medic and diagnostic tech. for 5 years at a training hospital. You would be astounded as to the realities that go on in such a place.

Sun, 04/21/2013 - 21:35 | 3482081 fonzannoon
fonzannoon's picture

I always thought humor was infectious.

Mon, 04/22/2013 - 01:52 | 3482717 Hobbleknee
Hobbleknee's picture

Doctors still use saws, and leeches have been replaced by maggots.

Mon, 04/22/2013 - 02:17 | 3482767 StychoKiller
StychoKiller's picture

Well, yeah, but in each instance, the maggots and saw(s) are sterilized between patient usages.  The question EVERYONE should be asking is this:  WHY does every market the Govt meddles in, end up with skyrocketing costs?

Mon, 04/22/2013 - 05:16 | 3482899 Parrotile
Parrotile's picture

The saws are both low-and high tech: depending on what you need sawn (e.g the Orthopods still use tools that bear a very uncanny resemblance to Tenon saws, or often Hacksaws!) Leeches are still very much in use, mainly in Reconstructive Plastic Surgey (to maintain vascular patency in e.g. skin flap grafting), whilst sterile blowfly maggots are very useful in management of necrotic wounds and ulcers - particularly vascular ulcers in the elderly and those with microvascular problems (read Diabetes - Insulin, and Non-Insulin dependent).

In order to not completely freak our Customers out, we usually refer to "our little friends" as Biosurgical Tools. Sounds a bit better then "you're going to have maggot or leech therapy!"

Mon, 04/22/2013 - 13:32 | 3484460 Miffed Microbio...
Miffed Microbiologist's picture

Yes, I always thought when I was walking into an Otho surgical suite I had the uncanny feeling that I had entered high school wood shop. ;-)

I remember a few year back doing a bleeding time on a trauma patient that was going back to surgery. She had a large fat black leech on her hand after a very difficult hand surgery. For a few minutes I took my eyes off of it when the nurse walked in with a new leech to replace it. All of a sudden I heard her exclaim " where did that leech go?!" we were about to check each other screaming when she found it had crawled under the patient having a little nap after a big meal. Mr miffed insisted he check my back before we went to bed that night!

Miffed;-)

Mon, 04/22/2013 - 00:01 | 3482236 Radical Marijuana
Radical Marijuana's picture

http://www.youtube.com/watch?v=gWLrfNJICeM

Cancer - The Forbidden Cures

The AMA was driven to become dominant by funding from the banksters, during the 20th Century, as briefly explained by a clip in that video from Griffin, who made the banksters' Jekyll Island meeting famous: http://en.wikipedia.org/wiki/G._Edward_Griffin.

For more links to the same kind of social shit concerning the runaway systems which profit from sicknesses:

PROFIT...FROM...DISEASE

Of course, the medical systems are actually inside of the military systems, although that is denied, because between medicine and militarism is the money system. The central feature was always the feedback of the funding of the political processes, becoming runaway triumphs of the profit from frauds, backed by force, being reinvested in paying for more legalized frauds, backed up with more legalized force.

Overall, the medical system now kills an order of magnitude more people than the military systems do. The medical systems now lead the way in corrupting the political processes, and therefore, have become the most profitable businesses, which are interconnected with the profit from junk food systems, and everything else similar that almost totally dominates American society, which is making a killing in every literal and metaphorical way possible.

All of the profitable soft-kill strategies have been extremely effective. However, they are still probably going to be trumped later by the imposition of outright democidal martial law, which the banksters' systems have been preparing for through a series of false flag attacks. The astronomically amplified magnitudes of EVIL controlling the current American, as well as mostly globalized systems, are so BIG as to be almost incomprehensible. In my view, it all goes back to militarism, whose success was based on being the best at deceits. That has enabled the development of a human ecology which operates through the maximum deceits possible, whereby millions and millions of Americans are routinely tortured to death, in ways which are quite profitable, despite the overall situation that America is thereby being tortured to death as a whole.

However, since there is practically zero chance of any saner public debate about basic human ecology issues, it is practically impossible to have any saner public debate about health care issues. One of the results of our real human ecology system being the result of the maximum possible deceits is that practically nobody discusses those issues in a sensible way. Instead, there has been one wave after another of Bizarre and more Bizarro Mirror World manifestations of things like "eugenics" turning into "disgenics," which thereby discredited eugenics, etc..

Since our REAL artificial selection systems were developed through force backed frauds, whereby the maximum possible deceits actually ran the death control systems, which then backed up the monetary and taxation systems, and everything else that almost completely corrupted governments did to legalize lies, and back those up with legalized violence, the "health care" system has degenerated into being about as BACKWARDS as it could possibly be ...

The degree to which that is BACKWARDS includes the ways that people deny the fundamental nature of life, which has inherent and innate political problems, which must be resolved in some way. What we have are sets of solutions to chronic political problems which have become runaway triumphant legalized lies, backed by legalized violence, which therefore are also the essential characteristic of the actual "profit from disease systems."

 

Mon, 04/22/2013 - 02:22 | 3482774 StychoKiller
StychoKiller's picture

Do you have any screwdrivers to go with your hammer?

Methinks the World/Universe is more complex than you realize.

Mon, 04/22/2013 - 17:57 | 3485610 Radical Marijuana
Radical Marijuana's picture

Both the screw drivers, as well as the hammers, are practically useless ... We are overwhelmed by tsunamis of triumphant financial frauds. I have been working on those problems for decades, only to prove over and over again that we are drowning in the utterly runaway funding of the political processes being in a positive feedback of legalized lies, backed by legalized violence, getting worse faster!

There are NO tools that I am aware of that can work on that problem. We are totally screwed, and there are no screw drivers which are available to us to counteract the already triumphant systems set up by the banksters, which almost totally dominated everything, including, of course, medicine!

I can do nothing more than try to hammer away at that, while I am being pounded flat by way, way bigger hammers!

P.S.

OF COURSE, the universe is infinitely more than I could imagine ... However, I do somewhat understand human beings using lies backed by violence, which are the primary things to understand our society.

Sun, 04/21/2013 - 22:16 | 3482301 Yen Cross
Yen Cross's picture

 I have put "4" well insured family members to rest over the last 5 years.  I'll banter and send pictures alll day long! BitchZ

  The undertaker deserves his profit. The undertaker goes to Hell if he doesn't! Bury people properly...

Sun, 04/21/2013 - 22:18 | 3482317 Miffed Microbio...
Miffed Microbiologist's picture

LTER,
2 words for you: defensive medicine. Hard to quantitate but pervasive in medicine today. Who wants to be sued because of not performing the one test that could have diagnosed the problem? Better run every test imaginable and reduce that risk. I see it done all the time. You see it as padding their pockets. I see it as avoiding lawyers.

Miffed:-)

Mon, 04/22/2013 - 02:01 | 3482737 LetThemEatRand
LetThemEatRand's picture

So seeking private redress through the Courts is wrong?

Mon, 04/22/2013 - 02:26 | 3482780 StychoKiller
StychoKiller's picture

No, what is wrong is expecting every Human body to agree with medical textbooks, thus making Physicians infallible.  Why do you think they call it "Practicing Medicine?"

From the "Bill of No Rights:"

ARTICLE V -- You do not have the right to free health care.

That would be nice but, from the looks of public housing, we're just not interested in government run health care.

Mon, 04/22/2013 - 02:33 | 3482788 LetThemEatRand
LetThemEatRand's picture

The Rule of Law that you assholes think is so important says that the doctor must be negligent (below the professional duty of care) to get a recovery.  But the corporate media has convinced you that the jury system that employs those laws is just giving money away.  Let's let the corporations decide.

Mon, 04/22/2013 - 13:41 | 3484494 Miffed Microbio...
Miffed Microbiologist's picture

Did I say it was wrong to redress with the courts? True incompetency and poor care should be punished. However, bad outcomes are NOT necesarily due to bad care. You are extraordinary biased and ignorant on this.

Miffed:-)

Mon, 04/22/2013 - 05:27 | 3482904 Parrotile
Parrotile's picture

Also known as "Following Best Current Practices" or "Following Site / Area / Regional Guidelines"

Even Senior Registrars / Advanced Trainees HAVE to follow the whims of the Admitting or Managing Consultants - "supposedly" the Admitting Team, but the Inpatient Labels that come from our Pharmacy always have the Admitting Consultant on them as "responsible entity".

No-one is that brave as to ignore a direct request from the Gods - 'cause if it goes wrong for ANY reason, they are in really deep s**t, and often "looking at a career change".

So, the system continues - excessive practices, unnecessary tests - 'cause the Consultants "need" them, so they are done, without question, 'cause you don't want to upset those in positions of serious power.

You'd (not) be surprised at the number of times we have Imaging reports asking why the exam was requested - and the same goes for Pathology. All money wasted.

Mon, 04/22/2013 - 19:03 | 3485793 WillyGroper
WillyGroper's picture

>>>>>And yet the public is almost universally convinced that the problem is lawsuits

So true. Sister & BIL/nurse/surgeon, both believed this until viewing docu "Hot Coffee".  The spin on that put the final nail in the coffin. No pun inteneded. 

Sun, 04/21/2013 - 21:59 | 3482242 vato poco
vato poco's picture

Uh-huh. Tell you what, tough guy: go sell that "crawl in a hole and die" macho bullshit to a 3-year-old girl dying of cancer. Then sell it to her 6-year-old brother. Then to her grieving parents, adrift in an ocean of agony. Better yet, let's make her *your* little girl. Go on, tough guy. Go tell *your* little daughter to go crawl in a hole and die. 

Dipshit.

Sun, 04/21/2013 - 22:17 | 3482310 LetThemEatRand
LetThemEatRand's picture

Charity is the answer, according to the ideologue crowd.  We all know that those with money will just line up to help every poor kid with cancer.  Or the good Father at the local church will give the kid holy water or something.

Mon, 04/22/2013 - 00:34 | 3482625 Overfed
Overfed's picture

HMOs are the reason why we are where we are today. Meaning healthcare wouldn't be so damn expensive if it weren't for the health insurance companies and big pharma.

And yes, doctors and hospitals need to be held accountable for incompetence and mistakes, but judgements in the $10s of millions or more are counter-productive.

Mon, 04/22/2013 - 01:15 | 3482652 LetThemEatRand
LetThemEatRand's picture

Overfed, HMO's were a way for health insurance companies to save money.  And if a jury of your peers awards your child several million dollars for a drunk doctor causing her a life time of being a vegatable, what do you propose?  Let the AMA decide how much the kid gets?  FUCK the Constitution and the jury system.

Sun, 04/21/2013 - 22:29 | 3482325 Pseudo Anonym
Pseudo Anonym's picture

i guess you preferred letting fucked up pharma cartels and their brain washed doctors pump your daughter with chemo drugs, let them blast her with radiation, saturate her with pain killers and all kinds of other voodoo cancer remedies to kill her slowly so that everybody upstream can make fat profits from her unfortunate illness.  it's not the cancer these days that kills.  it's the very profitable cure that kills people at the end.  there is absolutely no incentive for anybody to find a cure for cancer since cancer (and diabetes) is a fat cash cow for big pharma and hospitals.

edit: so, yes, since there is no cure for cancer, and i presume it was terminal cancer, your daughter was better off passing away quickly and with as little pain as possible as opposed to prolonging the inevitable in the most painful way so that big pharma and the rest of the quacks can profit along the way.  and you can bet that i am talking from my own personal experience.

Sun, 04/21/2013 - 20:15 | 3481818 A Lunatic
A Lunatic's picture

Ohhh Doctor, there's a surgical instrument in my abdominal cavity..............

Sun, 04/21/2013 - 21:42 | 3482165 Kirk2NCC1701
Kirk2NCC1701's picture

The cost of sick care is compounded by the litigious legal industry.

A good start is to limit litigation to actual damages.

Sun, 04/21/2013 - 22:18 | 3482315 LetThemEatRand
LetThemEatRand's picture

How do you define actual damages?  The current litigation system limits recovery to actual damages which include suffering pain that was not necessary.  Or is that worth nothing?  

Mon, 04/22/2013 - 01:48 | 3482712 Unique Snowflake
Unique Snowflake's picture

Of course it's worth nothing, you ignorant socialist moron. How does one define damages for the purpose of compensation? That's pretty fucking obvious, no? Actual and/or future monetary loss.

And no...."I can't flip burgers no more cos I'm so traumatised by that random infection I got while I was being saved from my obesity caused diabetic coma, in a hospital on the teet of the public purse, that I deserve damages due to loss of potential income from not being able to work cos I gots me the PTSD"...no. You can go fuck yourself. Socialism IS THE FUCKING PROBLEM. You entitled cunts, all think you deserve, deserve, deserve, without doing a goddamn thing for the society you live in. The irony is, you all think you are. Socialism(in your mind) = Kumbaya campfire singing and holding hands. Socialism(really) = state sponsored theft.

Mon, 04/22/2013 - 01:56 | 3482726 LetThemEatRand
LetThemEatRand's picture

I am 6 and I can't talk no more because a drunk doctor fucked up.  I'm white and my parents are successful.  But I have no history of income so fuck me, because I'm probably a socialist.  I have no right to seek redress of my private wrong because a big lobbyist convinced the sheep that doctors are all good and the Constitutional right to a jury trial sucks.  Dick.

Mon, 04/22/2013 - 02:30 | 3482783 StychoKiller
StychoKiller's picture

In a large part of the World, you might not receive any medical attention at all; should we then subsidize their sick care too?  Arguing for "fairness" in an unfair, and extremely hostile Universe seems a lot like tilting at windmills.

Mon, 04/22/2013 - 02:35 | 3482790 LetThemEatRand
LetThemEatRand's picture

Jesus.  

Mon, 04/22/2013 - 02:38 | 3482795 akak
akak's picture

Wept.

 

(At your stupidity)

Mon, 04/22/2013 - 02:55 | 3482804 LetThemEatRand
LetThemEatRand's picture

Go.  Fuck.  Yourself.  Rand.  Cultist.

Sun, 04/21/2013 - 20:19 | 3481835 Ayreos
Ayreos's picture

And this is nothing compared to the state of the actual medical science. You can still optimize hospital management, but can you change the minds of misled researchers as easily? Before hospitals, the science and the meds will kill you... when they don't fail to save you.

Sun, 04/21/2013 - 20:21 | 3481838 Miss Expectations
Miss Expectations's picture

This one is simple, the insurers simply add another billing code for Preventable Complications and take it off the bill...like a bad shrimp cocktail appetizer...

Found this interesting:

Ophthalmologists walk out of Obamacare talk at national medical meeting

http://twitchy.com/2013/04/21/ophthalmologists-walk-out-of-obamacare-tal...

Sun, 04/21/2013 - 20:33 | 3481874 toys for tits
toys for tits's picture

The opthalmologists can't see what's really going on.

Sun, 04/21/2013 - 21:02 | 3482013 LetThemEatRand
LetThemEatRand's picture

I got it.  Good one.

Mon, 04/22/2013 - 02:33 | 3482784 StychoKiller
StychoKiller's picture

Are perhaps, they're the only ones who saw clearly!

Mon, 04/22/2013 - 00:11 | 3482589 Edelweiss
Edelweiss's picture

  No, it really isn't that simple. Many will reject this idea, but the fact is that many patients contribute to their own preventable complications.  For example, if a patient refuses to wear sequential compression stockings, or heparin injections, should the hospital and/or physician be held responsible for resulting DVT's or pulmonary emboli?  Are the hospital staff at fault some of the time for complications? Of course they are.  That should be determined on a case by case basis.  This article doesn't mention the reality that many patients aren't compliant.  How do I know this?  Because I see it every time I go to work. 

Mon, 04/22/2013 - 02:34 | 3482786 StychoKiller
StychoKiller's picture

Which is just one more reason why Obamacare is destined to fail!

Mon, 04/22/2013 - 07:09 | 3482980 Miss Expectations
Miss Expectations's picture

OK. Fair enough.  Need ANOTHER billing code for Patient Non-Compliance Non-Reimbursable Patient Only Liability (not covered by HSA)

I see where this is going.

Sun, 04/21/2013 - 20:22 | 3481845 Jendrzejczyk
Jendrzejczyk's picture

Last month a good friend went in for a biopsy of a prostate problem. In the germ filled hospital he contracted a pulmonary infection. 10's of thousands of dollars later, he is doing ok now. The hospital is taking no responsibility and the insurance company is getting the bill.

Sun, 04/21/2013 - 21:53 | 3482221 Kirk2NCC1701
Kirk2NCC1701's picture

It's only fair that doctors and surgeons get outsourced also.

Tip for Tyler: Do an article for the many people who get elective surgery done Outside the US. For a fraction of the price.

Sun, 04/21/2013 - 22:31 | 3482357 Miffed Microbio...
Miffed Microbiologist's picture

This is true, health care abroad is much cheaper. However, if you get complications such as a surgical infection sometimes these places have highly resistant superbugs not found in the US.I have had a few patients flown back to the USA with life threatening infections from surgical tourism. For example, if you want a butt implant don't go to Honduras. Those 2 patients went through hell unimaginable and for cosmetic surgery!

Miffed;-)

Mon, 04/22/2013 - 02:15 | 3482761 Urban Redneck
Urban Redneck's picture

As opposed to the super-bugs they feed you in US hospitals which are only curable with their hundred-dollar-a-pill-super-meds and several nights in one of their less-than-luxurious accommodations where you are exposed to even more sick people and diseases.  

I'll pass on the US hospitals for anything other than trauma that I can't stitch up myself, and if I ever elect to buy some "services" from a hospital it would definitely not be a US hospital.  

Then there's the jet-setting Bilderburg crowd- who can fly anywhere, anytime and buy whatever medical services they chose, they seem to be buying American a lot less these days...

 

Mon, 04/22/2013 - 18:30 | 3485690 Parrotile
Parrotile's picture

"New Delhi Metallobetalactamase" - something you really DON'T want to encounter during your "Luxury Holiday with a spot of Surgery thrown in!"

"Better the bugs you know, than the ones you don't!"

Sun, 04/21/2013 - 22:41 | 3482366 NoDebt
NoDebt's picture

The medical version of "pay someone to dig a hole, pay another person to fill it in."

Sorry to hear about your friend. 

I lost my father-in-law recently for a similar reason.  My mother-in-law also had a stroke a couple years ago because they were trying to raise her blood pressure for a condition she had (they successfully got it from "low" to "normal" and immediately sent her home, never bothering to check if it just kept going up, which it did, until she had a stroke the next day).

I will admit I don't know enough to tell you how to fix this.  But like most things, I suspect if you don't actively watch out for yourself (or have family memebers watching out for you) it's another system you're going to get sucked into and spend a long-ass (expensive, painful) time getting out of.

Mon, 04/22/2013 - 12:14 | 3484061 Jena
Jena's picture

One thing is that you become as pro-active as you possibly can. 

BP abnormalities?  Buy a home blood pressure monitor.  They're relatively cheap, very accurate and an excellent way to monitor your blood pressure and heart rate.  If either of these two vital signs trend out of normal CALL THE DOCTOR, or if the BP is crazy high, GO TO THE ER.

Mon, 04/22/2013 - 02:37 | 3482791 StychoKiller
StychoKiller's picture

Good luck "proving" that the germs were inhaled inside the hospital!  I once tripped and fell and broke the tip of one finger, but try as I might, the sidewalk refused to compensate me for all the pain and suffering.

Sun, 04/21/2013 - 20:26 | 3481852 Everyman
Everyman's picture

These SICK FUCKS!

I am about fucking tired of these "educated enlightened" fucks whether a "Doctorate" in medicine or a "Doctorate" in economics.  As crooked as these fucks are their heads need a bullet or lopped off!  DAMN!  I thought it was just me seeing these things, but in reality hospitals are in the business of "Medical Products Distribution".

These fucks gotta GO!

Mon, 04/22/2013 - 00:02 | 3482574 FL_Conservative
FL_Conservative's picture

When a business concern can't pay its bills, even in the event of some catastrophe, we free-market types ask that the business be allowed to go through bankruptcy and restructure its debts while the collectivist government wants to use others' (i.e., the taxpayers') money to bail it out.  Which seems more humane?  And why should this work any differently for individuals?  Are we not all accountable for our own selves?

The REAL problem is government intervention (through Medicare, Medicaid and VA) and the facade of health insurance, which was standardized after WW2.   Both are responsible for driving the exponential growth of medical costs.

Mon, 04/22/2013 - 01:03 | 3482655 LetThemEatRand
LetThemEatRand's picture

So we can't have insurance which is collective?  We're not asking for handouts.  Big corporations are.

Mon, 04/22/2013 - 01:34 | 3482684 FreeMktFisherMN
FreeMktFisherMN's picture

LTER you make typical knee-jerk statist reactions. 

The problem is .gov has intervened in healthcare, and has led to tons of inefficiencies. In any other industry with competition, technology improvements lower costs-not in health care, though. Crony capitalism reigns supreme in this industry, and .gov alters incentives towards this 'insurance' mentality, whereas insurance really is meant to cover unforeseen things/disasters, like any other insurance (fire, etc.). Pols and lobbyists have convinced a great deal of people that health care provision is 'too big  to fail' basically, and  therefore cannot be subject to regular supply/demand mechanisms. 

People are cost-insulated right now, as instead of shopping around for the best deal (price and quality), it's all about 'I'm covered', and that's it. In a free market they couldn't charge these exorbitant prices, because they would be limited by what people could afford. It's like college tuitions going so high; remove the govt guaranteed loans, and colleges would have to slash costs. 

Basically as other posters have said above, there has been an abdication of personal responsibility and now it's this 'there's a pill for that' mentality that big pharma loves. Instead of proactive preventive measures that ordinarily would be rewarded with lower premiums or in other ways, costs are socialized. 

And the FDA is a monopoly, too. In a class I was taking this year, I shut down this typical statist student who was astonished to hear that I believed the FDA was not good. I don't care how 'well-intended' these people are; they're bureaucrats, they're spending others' money, and they themselves aren't subject to competition. In a free market demand would arise for companies to do due diligence on who are good doctors, etc. Obviously people don't have all day to research who is a quack, etc., so instead they'd hire Yelp- and Consumer Reports-like agencies who would compete on trustworthiness and price for the consumers' dollar in this sector. And the FDA has had tons of mistakes over the years, many monumental. 

 

As far as pre-existing conditions, the risk is there. By definition it's not just a risk; it's actually there. What I believe would happen is there would be more charitability by some companies for PR/reputation, and/or family members of people who have a condition would perhaps have leverage to say, 'I'll only do business with you if you give so and so coverage.' And don't underestimate charity, either. Maybe if people could keep all their income they would have more to give away, and charity is private, and is done first-hand discretion, instead of .gov doling out money and all the inefficiencies that happen there.

 

In short, competition and free markets give best results. Cosmetic surgeries like LASIK are not 'covered' yet are affordable and super reliable nowadays. And remember also that government by definition is nothing but force. Capitalism is synonymous with voluntaryism in my book. LTER seems to think that the high price regime is inherently going to be here, and doesn't realize the dynamics that come into play if free markets are allowed to occur, which would drive down costs (constrained by supply/demand mechanisms of any other marketplace). 

Mon, 04/22/2013 - 01:36 | 3482689 FreeMktFisherMN
FreeMktFisherMN's picture

and regarding malpractice, what is needed is private contracts being restored between patient/provider. Not this bureaucratic approach. And instead of judges who have no clue and reward randomly and arbitarily huge sums, the patient and provider would agree to a private arbitrator who specializes in health care/accidents, and both parties would only agree if it was a trustworthy/impartial arbitrator. This is what happens in free markets. 

Mon, 04/22/2013 - 01:47 | 3482709 LetThemEatRand
LetThemEatRand's picture

Judges don't award, juries do.  Under our Constitutional system.

Up arrow yourself much?

Mon, 04/22/2013 - 01:56 | 3482731 akak
akak's picture

He did not uparrow himself, I did that, you sorry and bitter bastard.

Mon, 04/22/2013 - 02:04 | 3482742 LetThemEatRand
LetThemEatRand's picture

Pathetic.  You claim to support the Constitution except when it is inconvient (private right to bring a Court action against a doctor, to be decided by a private jury).

Mon, 04/22/2013 - 01:47 | 3482706 LetThemEatRand
LetThemEatRand's picture

"People are cost-insulated right now, as instead of shopping around for the best deal (price and quality), it's all about 'I'm covered', and that's it. In a free market they couldn't charge these exorbitant prices"

I'm having a heart attack -- how much for the treatment?  Idiot ideologue.

Mon, 04/22/2013 - 01:53 | 3482722 akak
akak's picture

Look who is the ideologue!  The statist blow-hard, dishonest, bitter and disingenuous to the end.

I truly hate you, and if I knew you in real life, I have no doubt that I would not be willing to lift a finger to save your sorry and pathetic life.

Mon, 04/22/2013 - 02:05 | 3482744 LetThemEatRand
LetThemEatRand's picture

So fuck you you fuck.  And I have no doubt that you are not worth saving.

Mon, 04/22/2013 - 02:07 | 3482746 akak
akak's picture

Kill yourself already.

You are perhaps the most contemptible piece of dishonest, malicious, ignorant, malevolent shit ever to disgrace this forum.

Mon, 04/22/2013 - 02:06 | 3482749 LetThemEatRand
LetThemEatRand's picture

Fuck you.

Mon, 04/22/2013 - 02:09 | 3482750 akak
akak's picture

Too bad you (and only you) weren't standing next to that bomb in Boston.

For that, I would have cheered.

Mon, 04/22/2013 - 02:10 | 3482752 LetThemEatRand
LetThemEatRand's picture

Along with the flag waving fucktard frat boys who have no idea what the Constitution is.  Go Team!  Way to go.

Mon, 04/22/2013 - 01:47 | 3482707 akak
akak's picture

Excellent post FMFMN, and you not only said everything in response to the blinkered, pro-statist, pro-bureaucracy nonsense of LTER that I wanted to say, but much better than I could have said it as well.  Bravo!

Mon, 04/22/2013 - 01:49 | 3482713 LetThemEatRand
LetThemEatRand's picture

Ditto because I think for myself and I don't listen to corporate interests.  At all.

Mon, 04/22/2013 - 02:41 | 3482796 StychoKiller
StychoKiller's picture

[quote]In short, competition and free markets give best results. Cosmetic surgeries like LASIK are not 'covered' yet are affordable and super reliable nowadays.

[/quote]

Not only that, but LASIK eye surgery actually dropped in price(s) as quality improved!

Mon, 04/22/2013 - 19:24 | 3485846 WillyGroper
WillyGroper's picture

Let us know how you grow into that prescription.

Mon, 04/22/2013 - 09:48 | 3483454 FL_Conservative
FL_Conservative's picture

LTER,

Health insurance exacerbates the problem, not solves it.  The government is the reason why a doctor visit costs $200 when it should cost $40-50.  Doctors know that, in order to get their $40-50, they must charge the government $200.  Insurance has adopted the same mentality, which is why both are the problem and not part of the solution.  Costs would be far more reasonable and care ultimately much better if the government would have left patient care to be handled between the doctor and the patient.  But statists don't have any regulator that makes them stop or say "enough", because they're just so much smarter than everyone else.  So, if that fits your description, then the system has been basterdized and cronyized because of people like you.  Congratulate yourself for a job well done.

Sun, 04/21/2013 - 20:27 | 3481855 Bobportlandor
Bobportlandor's picture

Oh the story I could tell about my moms treatment in the hospital. They caused tens of thousands of additional charges from their screw ups.

All I can say is document every movement, treatment, lack of treatment, they do and prepare to sue.

And as far as sending them to a Rest Homes you might as well leave them in the hands of ww2 Nazi doctors.

Sun, 04/21/2013 - 20:38 | 3481890 Everyman
Everyman's picture

I remember in the late 80s and early 90s where they were all crying for "Medical Tort Reform"  Well they got that through, and now Obamacare.  What is the result???

That patient is the last thing the medical community will worry about, they need their copay, matching funds, fundraisers, and contributions.  Sounds like the political class any more, doesn't it?

Sun, 04/21/2013 - 20:42 | 3481896 The Continental
The Continental's picture

This article's premise akin to saying that a homeowner profits when his house burns down because he collects on the insurance policy. What rubbish.

As a service director in a large hospital, I can assure you that quality improvement and QC have become an obsession. And therein lies the problem. Here's what's happening right now on the ground. The CMS is passing down Clinical Critical Pathways, that is performance checklists, wherein hospital reimbursement is based on compliance. They have initially targeted the major DRGs such as Chest Pain-related admissions. What it boils down to is that your in-hospital care is dictated by government edict the instant your are admitted to an impacted diagnosis. So the hospital must do x, y and z on days 1, 2 and 3. Failure to comply reduces the hospital reimbursement. On paper, it seems logical, as these are based on outcomes of treatment of large numbers of patients. It's all driven by statisitcs. The problem is that the system is stone rigid. There is no room for innovation or creativity. Physicians are now slightly better than rubber stamps approving a group-think protocol. Patients are not widgets. Mass production lines and automated care plans may not constitute better care. But here we are. This is the new paradigm and all of us are powerless to question or stop it. With virtually everyone to be captive to a govenrment-run insurance program, you as patient will comply with the dictates of the care plan or you will not be covered. That means accepting vaccines, drugs (i.e. statins) and whatever else is mandated.

Good doctors and nurses are going to be in short supply real soon. Ironically, the new paradigm doesn't need good ones nor a lot of them. This should terrify all of us. It sure terrifies me and my nurse wife. My advice is lose weight, take supplements, lead a healthylow-stress lifestyle, get some sun, and try to stay healthy. You don't want to be a hospital patient in the future; I know I don't want to be one.

Sun, 04/21/2013 - 20:58 | 3481985 LetThemEatRand
LetThemEatRand's picture

How many physicians who work at your hospital make more than 7 figures?  Give me a fucking break.  There would be no shortage of doctors if medical schools did not charge hundreds of thousands of dollars for the price of a ticket, and if medicine were not seen as a path to wealth by most who attend medical school.    And do you claim that private insurance companies don't do the same shit re micromanaging care?  

Mon, 04/22/2013 - 02:47 | 3482799 StychoKiller
StychoKiller's picture

So sorry, but the number of Doctors is dropping for a reason;  soon, there will be TWO healthcare systems: 

1. Obamacare (and waiting lists), for the financially-challenged, and

2. The better healthcare system funded by private individuals. 

Get used to the notion.

Mon, 04/22/2013 - 05:50 | 3482915 Parrotile
Parrotile's picture

Interestingly this point was raised by the UK BMA in the 1970's - over a real concern that people were going into Medicine not because they wanted to be Doctors, and had a genuine interest in Patient care; rather, there was a "disturbing trend" where the Students were far more interested in "The Bottom Line" potential - big salary, and early retirement, with as little Patient contact as possible en route to their "retirement at age 50 in the Bahamas".

 

Sun, 04/21/2013 - 20:58 | 3481987 Everyman
Everyman's picture

"Physicians are now slightly better than rubber stamps approving a group-think protocol. Patients are not widgets. Mass production lines and automated care plans may not constitute better care. But here we are. This is the new paradigm and all of us are powerless to question or stop it."

BULLSHIT, Doctors and medical research centers, and Medical equpiment makers can ALL rasise holy hell to stop this shit.  They know it, and apparently YOU do to:

As a service director in a large hospital, I can assure you that quality improvement and QC have become an obsession. And therein lies the problem. Here's what's happening right now on the ground. The CMS is passing down Clinical Critical Pathways, that is performance checklists, wherein hospital reimbursement is based on compliance.

So YOU are saying YOU are the problem.  YOU need to speak up as those in the financial sector need to speak up.

"People crushed by law, have no hopes but from power. If laws are their enemies, they will be enemies to laws; and those who have much to hope and nothing to lose, will always be dangerous."

"All that is necessary for the triumph of evil is that good men do nothing."

Both of those is by Edmund Burke, they apply to YOU!


 

Sun, 04/21/2013 - 21:05 | 3482018 The Continental
The Continental's picture

You don't know jack shit my angry young man. The doctors have zero say and zero power to stop this. All they can do is vote with their feet and walk. And some are doing just that. I plan to retire in about 4 years myself.

Sun, 04/21/2013 - 21:09 | 3482026 LetThemEatRand
LetThemEatRand's picture

They don't so much walk, as drive away angry in their Bentleys and Porsches.  We all get sick and we all need medical care.   I am all for letting doctors charge whatever they want if they have paying customers who have the means to pay it, but there should be an alternative and right now there isn't.

Sun, 04/21/2013 - 21:14 | 3482047 The Continental
The Continental's picture

I drive a 10 year old Yukon with 190,000 miles. Most of my colleagues drive Toyotas and the like. A couple drive a Porsche. No Bentleys that I have ever seen.

Do you really think agitating for a class war against the doctors is a solution?

Sun, 04/21/2013 - 21:18 | 3482067 LetThemEatRand
LetThemEatRand's picture

No, not class warfare and I am all in favor of doctors making lots of money if they are really good and can find people who can afford to pay them.  The doctors I know live on golf courses and/or the beach and they drive cars that cost as much as the houses most of their patients own.  And I know quite a few doctors.  If you don't think that a large part of the problem is the cost of medical school and the expectation of many who go there that they will own said houses/Bentleys, I'd say you are not looking very hard.   

Sun, 04/21/2013 - 21:20 | 3482075 Everyman
Everyman's picture

It is not about the doctors driving Bentleys, if they care for their patients the SHOULD get the spoils, but what we have now is the HOSPITAL ADMINSITRATORS driving even MORE expensive cars than the Doctors.

The Doctors need to speak up.  They have been silent too long, for colleagues thas suck at what they do and need to be stopped from being doctors, to the Hospital Hegemony that they are part of.

Doctors were once "respected", just like bankers, and they give the same excuses as bankers when it comes to cleaning up THEIR ECONOMIC SECTOR.

Sun, 04/21/2013 - 21:38 | 3482151 Miffed Microbio...
Miffed Microbiologist's picture

I believe you continental! I have seen this with my own eyes. My friend's mother was having horrible health probems and her platelets were running around 10 when anything under 50 is critical. After numerous platelet transfusions didn't work they said her only option was a to remove her spleen. She said she didn't want to do that but wanted them to diagnose why her platelet level was so low. They said the only choice was to remove her spleen because that is what was next in the ridged care stream. She basically told them to fuck off and got a second opinion which she had to pay for out of pocket. Turns out she had severe gluten intolerance and when she gave up wheat her platelets quickly went to normal levels. When she went back to her hematologist he told her he was so happy she did what she did because removing her spleen would have been useless and would have created more medical problems for her. These diagnostic care streams are terrible! People are unique and trying to fit everyone into a care stream will result in worse outcomes! Fact is, see a great diagnostician when you have a difficult medical problem. See if he or she wants to take the time to figure out what is going on. A fantastic dr can out do any formula designed to eliminate errors.

Miffed;-)

Mon, 04/22/2013 - 01:16 | 3482657 LetThemEatRand
LetThemEatRand's picture

And who paid for all of this?   You or a collective that your family paid into in the event of a catastrophic illness?  Funny how collectivistm rocks when it benefits YOU.

Mon, 04/22/2013 - 02:51 | 3482802 StychoKiller
StychoKiller's picture

Reeding comprehenshun problems, huh?  The patient ended up paying for a better diagnosis, ya idjut!

Sun, 04/21/2013 - 21:22 | 3482063 Everyman
Everyman's picture

NO, YOU will not face reality.  Angry?  You betcha!  And there are more of me out there than anything you can produce.  We can't "Vote with our feet", PPO?  Remember that?  How about the HMOs?  Remember that screwup?  It is ALL manipulation from day 1, when hospitals started having a BOD and accountants trying to figure out to make "profits" with "patients". 

It is mutually exclusive.

Doctors SHOULD have the say, yet they all "vote with their feet" too.  That IS my point, they STAY in a corrupt and sociopathic system, believing they are alturistic humanitarians, that is until they have to switch from the BMS or other $100K car to something more in line with their patients???

You are so full of BS.

Sun, 04/21/2013 - 21:59 | 3482240 The Continental
The Continental's picture

I feel your pain, literally. I have had a bad headache all weekend. I usually feel this way on weekends. By Monday, I'm A-OK back to normal. Maybe I'm addicted to my job and the headache is withdrawal. Let me say this in blunt terms:  the entire cost structure of US healthcare is fricking insane! But, we are not supposed to care about cost. We are supposed to care about providing quality care and to do everyhting in our power to heal, and cost be damned. But after a few noble decades of golden high-minded medicine the costs have caught up with us all. Yes, it is true that some doctors are incentivized to do more so as to make more. In an environmwnt where no one cricitizes you for doing too much and threatens to sue you for not doing one thing, it's hard to get doctors into a cost-control mode. Frankly, most are so busy and patient cues backed up for months that the question is moot: they have plenty of work. They don't need incentives to do more. The dictates of the patient demands and fear of lawsuits have taken care of all that.

In doctors we as a society have produced a fleet of cadillacs and lexuses when the average American can barely afford a used Hyundae. But we are Americans as we deserve the best, right? Well, folks, we have some excellent care and lots of tests and technology and guess what: the whole enchilada is obscenely expensive. Modern healthcare is helping to impoversh the American society, believe it. It is a bubble.

Consider these kids graduating Med School now or recently. Tuitions are fricking insane, $50,000  .... per year! But they borrow it, pay the freight and fight to get into Med School. The schools are packed solid as applicants outnumber acceptance 10:1. I guess they think it a good investment. Then, on to 4-6 years of residency and fellowship working like a slave for a low-middle-cass salary. But again, these folk go in with eyes wide open. This is path they've chosen. So now where are we? These new docs are not getting big money thrown at the. On the contrary, salaries are down as contractual rates continually pressure physician pay lower. That's called competition I think. But not physician competition but payer competition. So be it. The point is, that new doc wakes up and realizes that he leveraged himslef to the tune of $250,000+ to wind up with a decent paying white collar job. Granted, good jobs are hard to come by. But now he'a got to live off that and pay back those loans. And he's 10 years older than everyone else in the bargain. To say he did all this to make a lot of money misses the point. From a dollars and sense perspective. becoming a doctor today is a total loser. That's the reality. It no different than the kid who pays $100K for a college diploma only to discover that there are no jobs and the diploma means jack shit in today's economy. On the other hand, if he entered medicine to be a healer and enjoy the pride and honor of being a great doctor, then he has succeeded despite long odds and deserves our congratulations.

By definition, anyone who enters medicine to make money has a very low finance IQ.

Sun, 04/21/2013 - 22:16 | 3482295 LetThemEatRand
LetThemEatRand's picture

So let's all pay for medical school for those qualified so we have doctors who don't need to make so much.  Works for most of the civilized world.  But that would affect your salary.

Sun, 04/21/2013 - 23:12 | 3482464 The Continental
The Continental's picture

Yeah, just like the Chevy Volt! How'd that one work out?

The answer is not to have "we the people" pay for educating doctors. The answer is liberalize licensing of medical schools to force them to compete for students and lower tuitions. And we must get the government out of the student loan business. If there were no readily available loans, most prospective students would walk away from today's tuitions out of necessity. Med school tuitions would come down to reality.

Frankly, the entire healthcare edifice is so screwed up, pumped full of costs, regulations, mandates, subsidies and padding that it probably cannot be reformed. It will soon collapse with the goverment finances that enable it. Then we can rebuild a better system. a system that provides healthcare rather than a money-making drug-pushing corporate-government behemoth. I think it's called fascism, BTW.

Mon, 04/22/2013 - 00:12 | 3482586 LetThemEatRand
LetThemEatRand's picture

Chevy Volt?  Ideologue much?  Go back to your very nice home and bitch about Obamacare in blissful wealthy silence, please.

Mon, 04/22/2013 - 01:55 | 3482718 akak
akak's picture

LTER, your specious arguments here are a classic example of the ignorant and the gullible demanding even MORE government intervention into, and appropriation of, economic activity in the name of "fixing" the problems caused by prior government intervention into, and appropriation of, economic activity.

Like the hopeless alcoholic or heroin addict, you are vainly hoping that more of what is killing you will fix the problems caused by that which is already killing you.  Isn't this a good definition of insanity?

Or, to sum it up in one sentence, "Government is a disease masquerading as its own cure".

Mon, 04/22/2013 - 02:18 | 3482768 LetThemEatRand
LetThemEatRand's picture

Yes, fuck the 6 year old with cancer because Ayn Rand (who I read my freshman year, where you are stuck) knew everything.  Fucking douche.

Mon, 04/22/2013 - 02:23 | 3482775 akak
akak's picture

No, just fuck the ignorant and/or malevolent statist bastards such as yourself who brought the multitudinous problems facing our increasingly government-dominated society upon all of us.

There is apparently no problem, in your eyes, that even MORE institutionalized coercion can not solve.  You are either insane, or evil.  Possibly both.

Mon, 04/22/2013 - 02:54 | 3482806 StychoKiller
StychoKiller's picture

I'm leaning towards myopically insane here...

You can't make someone understand what they're being paid NOT to understand.

Sun, 04/21/2013 - 22:21 | 3482322 Everyman
Everyman's picture

It is from day one, the insurance industry, the "hospital helath care Hegemony" meaning the for profit health care system, and Big Pharma. 

The costs of treatments such at the "scorpion venom antidote" some 81 year old lady got for $37,000 each for 2 doses.  In Mexico, it is $100.  That is because of Medicare/Medicaid.  Costs are artificially high.  ANd the corruption in the health care system rolls along.  The Big Pharma tells everyone to push statins, look at the damage they do.  Almost worse that the cholesterol.  I go to the GP, and all I get are tests and a prescription.  Never anything else, if there is ANY invasive procedure, it goes to a "specialists", like a finger cyst.  Not one Doctor of the three I saw even remotely touched it, all said go to a specialist.  Yet instead of surgery, the Medical Journals said aspiration therapy
which costs very little, basically lancing it with a syringe, is 75% effective.

NO< they can't do the lo cost procedure, got to go have a $4000-$9000 procedure IF I can get a price upfront.

 

You call that "Cadillac Procedures"????  That is BASIC medicine.  THAT is why I am pissed off.  BASIC is GONE.  Doctors of yesterday are GONE, and THOSE are what we need.

 

$100,000 of tuition does NOT train one to be a Doctor, just merely gets you the certificate.  We have a lot of Doctors that are not "DOCTORS".

Mon, 04/22/2013 - 00:43 | 3482638 Overfed
Overfed's picture

That's funny you mention Dr.s pushing statins. Every time I see my doc, he says "Hmm...your cholesterol is a little high, maybe you would like to consider taking Lipitor?" Nevermind that my total cholesterol has dropped from 260 to 220 over the last year, and my HDL is exactly where it should be. Fukkers. They're always tryin' to get ya' on a new fukkin' drug that you'll never stop taking.

Mon, 04/22/2013 - 01:05 | 3482659 LetThemEatRand
LetThemEatRand's picture

Do you pay cash when you see your doctor or are you part of a collective (insurance)?

Sun, 04/21/2013 - 22:06 | 3482270 Radical Marijuana
Radical Marijuana's picture

Well, The Continental, I agree with your points of view.

Mon, 04/22/2013 - 01:06 | 3482660 LetThemEatRand
LetThemEatRand's picture

And I disagree with him.  Brilliantly argued all around.

Mon, 04/22/2013 - 05:56 | 3482924 Parrotile
Parrotile's picture

Your not alone, sunbeam. In Australia, a lot of the GOOD staff (i.e. the Patient-focussed staff) are leaving.The ones remaining are the "box-tickers", and they are always the ones that get promoted.

Nothing quite like "promoting a culture of excellence" - translation - promoting the connected, and those who tick all the right boxes . . . . . . .

Sun, 04/21/2013 - 21:22 | 3482089 IMACOINNUT
IMACOINNUT's picture

Continental

You are spot on with your response, as a health care provider I am dealing with the critical pathways and their care provisions. Deviation from the pathways limits reimbursment and is not the always the best individualized care for the patient. And to add one tidbit of requests --patients quit coughing in the staffs face (for you self centered fucks). Us staff are always sick from the crap we daily deal with.

Sun, 04/21/2013 - 21:36 | 3482138 toys for tits
toys for tits's picture

Continental,

Your analogy of what this article was saying is inapplicable.

This article's premise akin to saying that a homeowner profits when his house burns down because he collects on the insurance policy. What rubbish. 

Now if the homeowner intentionally failed to extinguish the fire, he would profit by having a whole new house when he didn't deserve one.  While my analogy is closer, it is still wrong in that no ill intent was implied on the part of the medical community.

There is just no incentive to not fuck up medically.  How to remedy that is the problem.

If health insurance hadn't been given tax-free status, we wouldn't be in this mess today.

Sun, 04/21/2013 - 21:41 | 3482160 trillion_dollar...
trillion_dollar_deficit's picture

There is just no incentive to not fuck up medically.

 

Thats seriously the dumbest fucking comment Ive ever read on ZH in my 4 years here. You know nothing.

Sun, 04/21/2013 - 21:28 | 3482094 trillion_dollar...
trillion_dollar_deficit's picture

Just following up what The Continental said. This is way more complicated than the article portrays. Way more. Im a financial analyst in a large system. The first thing you have to understand is that what is defined as hospital "revenue" is completely irrelevant. The only thing that matters is reimbursement - ie what the payor is contracturally obligated to pay. Secondly, virtually every contract Ive modeled has carve outs for provider errors that are deemed responsible for longer stays. So, while the hospital may "charge" more for a longer stay due to error, they are no doubt losing money because they will not be reimbursed for that care. Medicare and Medicaid take care of this by something called the Case Mix Index and the Avg Length of Stay. It gets super complicated, but longer stays hurt hopitals because their reimbursement for the following year is calculated based on those (and other) measurements. Other things like readmission rates within 30 days also play large roles. I suspect that this NYT writer latched onto something about which they know nothing and tried to pump it up into something that its not.

Healthcare gets a bad rap. Some of it is completely legitimate. And thats fine. But, for all those who rail on the system, have no fear. Obamacare is about to completely destroy what we now know as healthcare in the US. In 10 years, the industry will be completely unrecognizable. So, all of you will be able to take some pleasure in whats coming.

In the meantime, as always I recommend finding out which companies own the hospitals in your area and to stay as far away as possible from those that are HMA owned.  

Sun, 04/21/2013 - 21:41 | 3482155 toys for tits
toys for tits's picture

You might want to reread the article.  This is from an AMA study.

Dr. Barry Rosenberg, an author and a managing director of Boston Consulting, said the study came about because his firm was working with Texas Health Resources to find ways to reduce its hospitals’ surgical complication rates, which, at 5.3 percent, were in line with those reported by similar hospitals. Part of that work involved analyzing the costs, and he said the team was stunned to realize that lowering the complication rates would actually cost the hospital money.

Sun, 04/21/2013 - 21:49 | 3482198 Everyman
Everyman's picture

Funny how Contenintal did not get this was from an AMA study.  Talk about talking out your arse.

Good post TOTs

Sun, 04/21/2013 - 22:08 | 3482271 LetThemEatRand
LetThemEatRand's picture

Continental profits from the system that exists today, and he fears that he will profit less if it changes.  Pretty obvious motivation.  Ordinarily I would not fault him for it, but as heathcare is something we all need like water and air, I do.  Of course Coca Cola Inc and Nestle Inc. think they own our water supply, so go fuck me if I think humans should collectively own anything.

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