Here’s the formula for the success of the American health care business model.
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 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. —NYTimes
Just dust aside that last sentence — it’s the obligatory ass-covering qualifier to limit character assassination, and besides, it’s obviously untrue. This is exactly how hospital administrators manipulate patient care, sacrificing health for dollars. That’s their job.
All of us have stories, some personal, some from a family member, neighbor, friend, or colleague, about the horrors of a hospital stay gone wrong. By now we’ve heard everything from accidental death and life-threatening infections to misplaced paperwork and identity theft. Just keep in mind that for any reason whatsoever, the longer your ass is confined to a hospital bed, the clock is running, which means you’re making money for the facility. And making money is why they’re in business, like everybody else.
Anybody else see a problem here?
Here’s how these numbers look:
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.
I have these visions of medical personnel, wearing “I Heart MRSA” tee shirts, passing around patient charts and high-fiving whenever they disscover an infected incision. “Three extra days! Another another 8 G’s!”
It’s a great system where the health care facility has a financial incentive to cultivate infections in their patients, or create an pneumonia-friendly environment. Maybe that’s why they keep those rooms and corridors cold enough to hang meat.
As long as we continue to reward businesses for failure, perversely underwriting harmful behavior that stands in 180-degree opposition to the profession’s mission, this model will prevail, because this model describes the way health care is practiced, and too many very powerful interests have too much at stake to bring about change.
My best advice: don’t get sick, don’t hurt yourself, and avoid hospitals. It’s life and death.