15 ms·

Hold up. We already have to pay through the nose for medical care, so where is all this money going that these hospitals need to ask for more? Is non-profit a d

Hold up. We already have to pay through the nose for medical care, so where is all this money going that these hospitals need to ask for more? Is non-profit a different class that is somehow left out of the con that is the US healthcare system?

BucketSort 8y ago
Administration bloat. I really wish costs were more transparent so we could reason about what drives cost. Doesn't seem sustainable that Hospitals are businesses, but that's the capitalistic way of solving things.
- EpicEng 8y ago
  >Administration bloat. I really wish costs were more transparent so we could reason about what drives cost. The second sentence seems to contradict the first. What about the insurance providers?
  - BucketSort 8y ago
    That's what is typically said about hospitals and other institutions (like universities). But I don't really know, because the cost of medical care in this country is obscured beyond belief. Check out the horror multitude of horror stories people have in figuring out the costs they incurred at hospitals.
- vkou 8y ago
  It's both administration bloat, and doctor salaries. Doctors in the US get saddled with mountains of student debt, and then make mountains of money, once they pay it off.
  - EpicEng 8y ago
    Don't forget they also have to pay malpractice insurance and, you know, have a highly specialized job which requires a whole lot of training.
    - barbecue_sauce 8y ago
      Specialized training, the supply of which is artificially constrained by the AMA/RUC.
      - EpicEng 8y ago
        Is it? Genuine question, I don't know anything about that.
        smileysteve 8y ago
        https://thescotandscotland.wordpress.com/2015/08/19/american-healthcare-ama-monopoly/ https://thescotandscotland.wordpress.com/2015/08/19/american...
        moorhosj 8y ago
        Yes, similar regulatory capture happens in most accredited professions, like lawyers (bar exam), accountants (CPA) and finance professionals (CFA). It benefits the people who have already achieved the certification to make it harder for others to achieve (limit supply to increase their pricing power). The AMA also actively lobbies against proposals to give nurse practitioners more patient access. [1] [1] https://www.ama-assn.org/press-center/ama-statements/ama-statement-va-proposed-rule-advanced-practice-nurses https://www.ama-assn.org/press-center/ama-statements/ama-sta...
        kgwgk 8y ago
        Are the CPA or CFA harder to achieve than in the past?
        moorhosj 8y ago
        Very hard to quantify this. CFA pass rates have trended down since the 60s, for all three tests [1]. However, it could just be that more people are taking it or less-prepared people are taking it. Also worth noting that things like derivatives, alternatives, and international standards (GIPS, FRA) weren't on the exam in the 60s. I'm having a harder time finding pass rates for the CPA before 2006. They seem to have gone up a little in that 12 year window 2006-2017 [2]. The tax code has also gotten larger and more complex over the past 50 years, so that is worth noting. [1] https://analystprep.com/blog/cfa-historical-pass-rates/ https://analystprep.com/blog/cfa-historical-pass-rates/ [2] https://en.wikipedia.org/wiki/Uniform_Certified_Public_Accountant_Examination#History_of_exam_formats https://en.wikipedia.org/wiki/Uniform_Certified_Public_Accou...
- zozbot123 8y ago
  Aren't a lot of these hospitals where "admin bloat" is an issue, actually non-profit? That doesn't strike me as very capitalistic. Capitalistic enterprises have residual claimants, who hold formal equity in the business and thus face a crystal-clear incentive to minimize costs and maximize perceived quality-of-service. Non-profits don't.
  - kiba 8y ago
    You expect megacorporations to not be bloated?
    - bawana 8y ago
      non profit does not mean low salaries. They pay themselves enough to just run a little red ink so they can cry to the state.
- TheAceOfHearts 8y ago
  Define "capitalism" [0]: an economic system characterized by private or corporate ownership of capital goods, by investments that are determined by private decision, and by prices, production, and the distribution of goods that are determined mainly by competition in a free market. Define "free market" [1]: an economic market or system in which prices are based on competition among private businesses and not controlled by a government. (Note: the first definition is a bit vague, so I used the second entry.) Hospitals aren't competing in a free market. They don't suck because of capitalism, they suck because of government intervention. Right now our medical system is basically the worst of both worlds--it's not affordable nor universal. If hospitals and doctors were operating in a free market then it would lead to lower prices and an increase in quality. You can see some evidence of this in medical areas which aren't typically covered by insurance and are less heavily regulated, with laser eye surgery probably being one of the best examples. You've managed to identify that the problem is government intervention, yet you appear to hint at trying to solve the problem with even more government intervention? Historically that hasn't gone over very well. Have you seriously considered alternatives? I believe a medical system cannot provide more than two of the following three guarantees: affordability, quality, and universality. This will probably be an unpopular opinion, but I think dropping universality is the best choice. You can still maintain a social safety net to catch people that fall through the cracks, and I posit that it would be cheaper and superior to our current system. [0] https://www.merriam-webster.com/dictionary/capitalism https://www.merriam-webster.com/dictionary/capitalism [1] https://www.merriam-webster.com/dictionary/free%20market https://www.merriam-webster.com/dictionary/free%20market
- cmiles74 8y ago
  I honestly believe that the ongoing battle between hospitals and insurance companies are a big contributor to the problem. After that, I think short-sited management is a big issue as well as the ever increasing executive compensation.
toomuchtodo 8y ago
> We already have to pay through the nose for medical care, so where is all this money going that these hospitals need to ask for more? Private insurance companies. EDIT: Out of network specialists. Pharmaceutical companies.
- sp332 8y ago
  Wouldn't paying for insurance be separate from a bill from the hospital? If I'm paying for medical care then that money isn't going to the insurance company.
  - toomuchtodo 8y ago
    You require care. Insurance company agrees to pay X. They pay X to hospital. This has no relation to the actual cost of the care you received. Hospital, you, and the uninsured split what health insurance doesn't pay for. That remainder has to come from somewhere.
    - sp332 8y ago
      Sorry are you saying the rates that are negotiated by insurance companies are too low to cover the actual costs of the hospital? That still doesn't explain where the money is going and why healthcare is so expensive. Why would the hospitals' costs be so high?
      - toomuchtodo 8y ago
        Please don't be sorry! I have done a lot of research into this, as I've been overly exposed to exorbitant healthcare costs, insurance appeals processes, and medical debt negotiation and settlement. This caused me to dig deep to find out why. My email is in my profile, I am happy to discuss at length and even hop on a phone call. https://www.forbes.com/sites/robertpearl/2017/11/07/hospitals-losing-millions/ https://www.forbes.com/sites/robertpearl/2017/11/07/hospital... > Three factors contributed to the need for layoffs: (1) reduced reimbursements from payers, including the Massachusetts government, which limits annual growth in healthcare spending to 3.6%, a number that will drop to 3.1% next year, (2) high capital costs, both for new buildings and for the hospital’s electronic health record (EHR) system, and (3) high labor expenses among its largely unionized workforce. > That, along with higher labor and drug costs, explained the Cleveland Clinic’s economic headwinds, according to outgoing CEO Dr. Toby Cosgrove. And though he did not specifically reference Medicare, years of flat reimbursement levels have resulted in the program paying only 90% of hospital costs for the “older,” “sicker” and “more expensive” patients. > The challenges confronting these hospital giants mirror the difficulties nearly all community hospitals face. Relatively flat Medicare payments are constraining revenues. The payer mix is shifting to lower-priced patients, including those on Medicaid. Many once-profitable services are moving to outpatient venues, including physician-owned “surgicenters” and diagnostic facilities. And as one of the most unionized industries, hospitals continue to increase wages while drug companies continue raising prices – at three times the rate of healthcare inflation. > With pressure mounting, hospital administrators find themselves wedged deeper between a rock and a hard place. They know doctors, nurses, and staff will fight the changes required to boost efficiency, especially those that involve increasing productivity or lowering headcount. But at the same time, their bargaining power is diminishing as health-plan consolidation continues. The four largest insurance companies now own 83% of the national market. Possible solutions: * Government sponsorship through HHS of electronic medical records management. Have USDS and 18F to spearhead the project (cc matt_cutts), leveraging their experience revamping technology service delivery within the VA. This removes Epic's profit out of the equation. * Government management of insurance. Medicare participants are fairly satisfied with it, and it can be just as efficient as Social Security. Cover everyone with Medicare, increase Medicare payroll deductions accordingly, and leave private insurance for additional fanciness some may desire (private rooms instead of shared rooms in hospitals, for example). This removes most of the profit from private medical insurance. * Make it illegal to advertise drugs to consumers (this is only legal in the US and New Zealand). You immediately eliminate billions (estimates are ~$20 billion/annually) of marketing spend by pharma, and therefore costs they will desire to recoup. * Let Medicare negotiate drug prices. This reduces profit realized from pharma concerns. * Remove limits on medical students and residencies to increase GP and specialist supply. Streamline the process of nurses leveling up to nurse practitioners. This reduces the profit motive for practitioners; you'll make a decent wage, but not Lambo money. * Subsidize medical school to prevent the need to go hundreds of thousands of dollars into debt to become an MD.
rootusrootus 8y ago
Ha, most of the nonprofits in health care are actually extremely profitable.
- writepub 8y ago
  Like most non profits in tech (Mozilla, Wikipedia, EFF, ...)
- maxxxxx 8y ago
  Being a non-profit exec is often extremely well-paid.
alrs 8y ago
Nonprofit means there aren't investors being paid a dividend, you can still have a cluster of management parasites getting paid $1M/yr.
- AnaniasAnanas 8y ago
  The same thing applies even to Mozilla https://news.ycombinator.com/item?id=10101637 https://news.ycombinator.com/item?id=10101637. Wikipedia is significantly better but still not perfect https://foundation.wikimedia.org/w/index.php?page=49&title=File:Wikimedia_Foundation_2015_Form_990.pdf https://foundation.wikimedia.org/w/index.php?page=49&title=F.... I honestly believe any company as well as everyone responsible for abusing the term "non-profit" in order to make money for their personal gain should be punished accordingly and be treated as scammers.
  - oarabbus_ 8y ago
    Most egregious might be the National Football League. Oh, and (mega)churches.
    - intuitionist 8y ago
      The NFL is no longer incorporated as a non-profit.
      - oarabbus_ 8y ago
        Thank god. Now we just need to not exempt the megachurches.
capdeck 8y ago
From the article: > Ms. Grupp, 66, said she wasn’t rich, and was disturbed by the letter. “I kind of resent it,” she said. “I don’t think they need the money.” The hospital last year reported nearly $48 million in net income and paid its chief executive officer $1 million. This is where it goes. That said, if I could spare $200k, I would if I had the information about which % of that money went to actual equipment and patient services. I think that information is available for non-profits, but I am not sure about hospitals. There will always be admin waste, but the best way to decrease it is to reward more efficient hospitals.
- JumpCrisscross 8y ago
  > I would if I had the information about which % of that money went to actual equipment and patient services Money is fungible.
- zanny 8y ago
  I still wouldn't even if I had the money because if you get 500k in donations for equipment and staff salary thats 500k you can take out of your revenue to line the pockets of executives.
- lithos 8y ago
  You can get these ratios for many charities and nonprofits from the combined federal campaign: https://cfcgiving.opm.gov/offerings https://cfcgiving.opm.gov/offerings Some really popular charities go well above 25% towards non-cause expenses like administration/advertising.
  - CompelTechnic 8y ago
    Advertising for charity has some funny game theory implications. A given charity often observes that every dollar of advertising increases contributions by 2 dollars. They the justifyably continue increasing their advertising budget until it reaches saturation, and every dollar of advertising only brings in $1.01 (more or less). If you assume that this advertising in net increases the size of the pie of charitable giving, it can be considered an overall good thing. If you assume that this advertising in net just redistributes the contributions that would go to one slice of the pie to another, it is wasteful. Data on which side is true is hard to come by.
chrisan 8y ago
Depends on if a hospital takes medicare/low income people (and if they do what % of them make up their patient population). They do not make profits off them and instead rely on wage earning people with insurance to cover the loss.
Shivetya 8y ago
government rules and regulations have so distorted the health care system that the system is breaking. it isn't that health care is expensive, its the hoops and restrictions placed on it that make health care expensive. recent new hospital in my area of the country was only allowed to open provided they did not take away business from other hospitals. This includes opening a second outpatient surgery room in an existing hospital to offering advanced cancer treatment. This is very common in the US. It usually goes under the name "Certificate of Need". The reasoning is that health care is improved if health providers do not duplicate expensive services. this has grossly driven up costs in many areas. then throw in rules which can force Emergency Centers out of network for ALL insurers. See a recent example in San Francisco with a PUBLIC hospital [1] TL;DR Health care is only this overly expensive because politician meddling. From preventing competition among hospitals to preventing competition among insurers, unless of course you donate properly. [1] https://www.beckershospitalreview.com/finance/zuckerberg-hospital-is-out-of-network-with-all-private-insurers-leaving-patients-with-massive-bills.html https://www.beckershospitalreview.com/finance/zuckerberg-hos...
- FireBeyond 8y ago
  > recent new hospital in my area of the country was only allowed to open provided they did not take away business from other hospitals. This includes opening a second outpatient surgery room in an existing hospital to offering advanced cancer treatment. This is very common in the US. It usually goes under the name "Certificate of Need". > TL;DR Health care is only this overly expensive because politician meddling. Certificated of Need were something _hospitals_ themselves lobbied for. It's a case of "this is awesome when it protects me, and an aberration when I'm on the losing end". Certainly politicians enacted such things, but I'm not losing sleep over the hospitals. Only us mortals, stuck with the cost of the system.

BucketSort 8y ago

Administration bloat. I really wish costs were more transparent so we could reason about what drives cost. Doesn't seem sustainable that Hospitals are businesses, but that's the capitalistic way of solving things.

EpicEng 8y ago
>Administration bloat. I really wish costs were more transparent so we could reason about what drives cost. The second sentence seems to contradict the first. What about the insurance providers?
- BucketSort 8y ago
  That's what is typically said about hospitals and other institutions (like universities). But I don't really know, because the cost of medical care in this country is obscured beyond belief. Check out the horror multitude of horror stories people have in figuring out the costs they incurred at hospitals.
vkou 8y ago
It's both administration bloat, and doctor salaries. Doctors in the US get saddled with mountains of student debt, and then make mountains of money, once they pay it off.
- EpicEng 8y ago
  Don't forget they also have to pay malpractice insurance and, you know, have a highly specialized job which requires a whole lot of training.
  - barbecue_sauce 8y ago
    Specialized training, the supply of which is artificially constrained by the AMA/RUC.
    - EpicEng 8y ago
      Is it? Genuine question, I don't know anything about that.
      - smileysteve 8y ago
        https://thescotandscotland.wordpress.com/2015/08/19/american-healthcare-ama-monopoly/ https://thescotandscotland.wordpress.com/2015/08/19/american...
      - moorhosj 8y ago
        Yes, similar regulatory capture happens in most accredited professions, like lawyers (bar exam), accountants (CPA) and finance professionals (CFA). It benefits the people who have already achieved the certification to make it harder for others to achieve (limit supply to increase their pricing power). The AMA also actively lobbies against proposals to give nurse practitioners more patient access. [1] [1] https://www.ama-assn.org/press-center/ama-statements/ama-statement-va-proposed-rule-advanced-practice-nurses https://www.ama-assn.org/press-center/ama-statements/ama-sta...
        kgwgk 8y ago
        Are the CPA or CFA harder to achieve than in the past?
        moorhosj 8y ago
        Very hard to quantify this. CFA pass rates have trended down since the 60s, for all three tests [1]. However, it could just be that more people are taking it or less-prepared people are taking it. Also worth noting that things like derivatives, alternatives, and international standards (GIPS, FRA) weren't on the exam in the 60s. I'm having a harder time finding pass rates for the CPA before 2006. They seem to have gone up a little in that 12 year window 2006-2017 [2]. The tax code has also gotten larger and more complex over the past 50 years, so that is worth noting. [1] https://analystprep.com/blog/cfa-historical-pass-rates/ https://analystprep.com/blog/cfa-historical-pass-rates/ [2] https://en.wikipedia.org/wiki/Uniform_Certified_Public_Accountant_Examination#History_of_exam_formats https://en.wikipedia.org/wiki/Uniform_Certified_Public_Accou...
zozbot123 8y ago
Aren't a lot of these hospitals where "admin bloat" is an issue, actually non-profit? That doesn't strike me as very capitalistic. Capitalistic enterprises have residual claimants, who hold formal equity in the business and thus face a crystal-clear incentive to minimize costs and maximize perceived quality-of-service. Non-profits don't.
- kiba 8y ago
  You expect megacorporations to not be bloated?
  - bawana 8y ago
    non profit does not mean low salaries. They pay themselves enough to just run a little red ink so they can cry to the state.
TheAceOfHearts 8y ago
Define "capitalism" [0]: an economic system characterized by private or corporate ownership of capital goods, by investments that are determined by private decision, and by prices, production, and the distribution of goods that are determined mainly by competition in a free market. Define "free market" [1]: an economic market or system in which prices are based on competition among private businesses and not controlled by a government. (Note: the first definition is a bit vague, so I used the second entry.) Hospitals aren't competing in a free market. They don't suck because of capitalism, they suck because of government intervention. Right now our medical system is basically the worst of both worlds--it's not affordable nor universal. If hospitals and doctors were operating in a free market then it would lead to lower prices and an increase in quality. You can see some evidence of this in medical areas which aren't typically covered by insurance and are less heavily regulated, with laser eye surgery probably being one of the best examples. You've managed to identify that the problem is government intervention, yet you appear to hint at trying to solve the problem with even more government intervention? Historically that hasn't gone over very well. Have you seriously considered alternatives? I believe a medical system cannot provide more than two of the following three guarantees: affordability, quality, and universality. This will probably be an unpopular opinion, but I think dropping universality is the best choice. You can still maintain a social safety net to catch people that fall through the cracks, and I posit that it would be cheaper and superior to our current system. [0] https://www.merriam-webster.com/dictionary/capitalism https://www.merriam-webster.com/dictionary/capitalism [1] https://www.merriam-webster.com/dictionary/free%20market https://www.merriam-webster.com/dictionary/free%20market
cmiles74 8y ago
I honestly believe that the ongoing battle between hospitals and insurance companies are a big contributor to the problem. After that, I think short-sited management is a big issue as well as the ever increasing executive compensation.

toomuchtodo 8y ago

> We already have to pay through the nose for medical care, so where is all this money going that these hospitals need to ask for more? Private insurance companies. EDIT: Out of network specialists. Pharmaceutical companies.

sp332 8y ago
Wouldn't paying for insurance be separate from a bill from the hospital? If I'm paying for medical care then that money isn't going to the insurance company.
- toomuchtodo 8y ago
  You require care. Insurance company agrees to pay X. They pay X to hospital. This has no relation to the actual cost of the care you received. Hospital, you, and the uninsured split what health insurance doesn't pay for. That remainder has to come from somewhere.
  - sp332 8y ago
    Sorry are you saying the rates that are negotiated by insurance companies are too low to cover the actual costs of the hospital? That still doesn't explain where the money is going and why healthcare is so expensive. Why would the hospitals' costs be so high?
    - toomuchtodo 8y ago
      Please don't be sorry! I have done a lot of research into this, as I've been overly exposed to exorbitant healthcare costs, insurance appeals processes, and medical debt negotiation and settlement. This caused me to dig deep to find out why. My email is in my profile, I am happy to discuss at length and even hop on a phone call. https://www.forbes.com/sites/robertpearl/2017/11/07/hospitals-losing-millions/ https://www.forbes.com/sites/robertpearl/2017/11/07/hospital... > Three factors contributed to the need for layoffs: (1) reduced reimbursements from payers, including the Massachusetts government, which limits annual growth in healthcare spending to 3.6%, a number that will drop to 3.1% next year, (2) high capital costs, both for new buildings and for the hospital’s electronic health record (EHR) system, and (3) high labor expenses among its largely unionized workforce. > That, along with higher labor and drug costs, explained the Cleveland Clinic’s economic headwinds, according to outgoing CEO Dr. Toby Cosgrove. And though he did not specifically reference Medicare, years of flat reimbursement levels have resulted in the program paying only 90% of hospital costs for the “older,” “sicker” and “more expensive” patients. > The challenges confronting these hospital giants mirror the difficulties nearly all community hospitals face. Relatively flat Medicare payments are constraining revenues. The payer mix is shifting to lower-priced patients, including those on Medicaid. Many once-profitable services are moving to outpatient venues, including physician-owned “surgicenters” and diagnostic facilities. And as one of the most unionized industries, hospitals continue to increase wages while drug companies continue raising prices – at three times the rate of healthcare inflation. > With pressure mounting, hospital administrators find themselves wedged deeper between a rock and a hard place. They know doctors, nurses, and staff will fight the changes required to boost efficiency, especially those that involve increasing productivity or lowering headcount. But at the same time, their bargaining power is diminishing as health-plan consolidation continues. The four largest insurance companies now own 83% of the national market. Possible solutions: * Government sponsorship through HHS of electronic medical records management. Have USDS and 18F to spearhead the project (cc matt_cutts), leveraging their experience revamping technology service delivery within the VA. This removes Epic's profit out of the equation. * Government management of insurance. Medicare participants are fairly satisfied with it, and it can be just as efficient as Social Security. Cover everyone with Medicare, increase Medicare payroll deductions accordingly, and leave private insurance for additional fanciness some may desire (private rooms instead of shared rooms in hospitals, for example). This removes most of the profit from private medical insurance. * Make it illegal to advertise drugs to consumers (this is only legal in the US and New Zealand). You immediately eliminate billions (estimates are ~$20 billion/annually) of marketing spend by pharma, and therefore costs they will desire to recoup. * Let Medicare negotiate drug prices. This reduces profit realized from pharma concerns. * Remove limits on medical students and residencies to increase GP and specialist supply. Streamline the process of nurses leveling up to nurse practitioners. This reduces the profit motive for practitioners; you'll make a decent wage, but not Lambo money. * Subsidize medical school to prevent the need to go hundreds of thousands of dollars into debt to become an MD.

rootusrootus 8y ago

Ha, most of the nonprofits in health care are actually extremely profitable.

writepub 8y ago
Like most non profits in tech (Mozilla, Wikipedia, EFF, ...)
maxxxxx 8y ago
Being a non-profit exec is often extremely well-paid.

alrs 8y ago

Nonprofit means there aren't investors being paid a dividend, you can still have a cluster of management parasites getting paid $1M/yr.

AnaniasAnanas 8y ago
The same thing applies even to Mozilla https://news.ycombinator.com/item?id=10101637 https://news.ycombinator.com/item?id=10101637. Wikipedia is significantly better but still not perfect https://foundation.wikimedia.org/w/index.php?page=49&title=File:Wikimedia_Foundation_2015_Form_990.pdf https://foundation.wikimedia.org/w/index.php?page=49&title=F.... I honestly believe any company as well as everyone responsible for abusing the term "non-profit" in order to make money for their personal gain should be punished accordingly and be treated as scammers.
- oarabbus_ 8y ago
  Most egregious might be the National Football League. Oh, and (mega)churches.
  - intuitionist 8y ago
    The NFL is no longer incorporated as a non-profit.
    - oarabbus_ 8y ago
      Thank god. Now we just need to not exempt the megachurches.

capdeck 8y ago

From the article: > Ms. Grupp, 66, said she wasn’t rich, and was disturbed by the letter. “I kind of resent it,” she said. “I don’t think they need the money.” The hospital last year reported nearly $48 million in net income and paid its chief executive officer $1 million. This is where it goes. That said, if I could spare $200k, I would if I had the information about which % of that money went to actual equipment and patient services. I think that information is available for non-profits, but I am not sure about hospitals. There will always be admin waste, but the best way to decrease it is to reward more efficient hospitals.

JumpCrisscross 8y ago
> I would if I had the information about which % of that money went to actual equipment and patient services Money is fungible.
zanny 8y ago
I still wouldn't even if I had the money because if you get 500k in donations for equipment and staff salary thats 500k you can take out of your revenue to line the pockets of executives.
lithos 8y ago
You can get these ratios for many charities and nonprofits from the combined federal campaign: https://cfcgiving.opm.gov/offerings https://cfcgiving.opm.gov/offerings Some really popular charities go well above 25% towards non-cause expenses like administration/advertising.
- CompelTechnic 8y ago
  Advertising for charity has some funny game theory implications. A given charity often observes that every dollar of advertising increases contributions by 2 dollars. They the justifyably continue increasing their advertising budget until it reaches saturation, and every dollar of advertising only brings in $1.01 (more or less). If you assume that this advertising in net increases the size of the pie of charitable giving, it can be considered an overall good thing. If you assume that this advertising in net just redistributes the contributions that would go to one slice of the pie to another, it is wasteful. Data on which side is true is hard to come by.

chrisan 8y ago

Depends on if a hospital takes medicare/low income people (and if they do what % of them make up their patient population). They do not make profits off them and instead rely on wage earning people with insurance to cover the loss.

Shivetya 8y ago

government rules and regulations have so distorted the health care system that the system is breaking. it isn't that health care is expensive, its the hoops and restrictions placed on it that make health care expensive. recent new hospital in my area of the country was only allowed to open provided they did not take away business from other hospitals. This includes opening a second outpatient surgery room in an existing hospital to offering advanced cancer treatment. This is very common in the US. It usually goes under the name "Certificate of Need". The reasoning is that health care is improved if health providers do not duplicate expensive services. this has grossly driven up costs in many areas. then throw in rules which can force Emergency Centers out of network for ALL insurers. See a recent example in San Francisco with a PUBLIC hospital [1] TL;DR Health care is only this overly expensive because politician meddling. From preventing competition among hospitals to preventing competition among insurers, unless of course you donate properly. [1] https://www.beckershospitalreview.com/finance/zuckerberg-hospital-is-out-of-network-with-all-private-insurers-leaving-patients-with-massive-bills.html https://www.beckershospitalreview.com/finance/zuckerberg-hos...

FireBeyond 8y ago
> recent new hospital in my area of the country was only allowed to open provided they did not take away business from other hospitals. This includes opening a second outpatient surgery room in an existing hospital to offering advanced cancer treatment. This is very common in the US. It usually goes under the name "Certificate of Need". > TL;DR Health care is only this overly expensive because politician meddling. Certificated of Need were something _hospitals_ themselves lobbied for. It's a case of "this is awesome when it protects me, and an aberration when I'm on the losing end". Certainly politicians enacted such things, but I'm not losing sleep over the hospitals. Only us mortals, stuck with the cost of the system.