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Administration bloat. I really wish costs were more transparent so we could reason about what drives cost. Doesn't seem sustainable that Hospitals are businesse
by 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 agoThat'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 agoIt'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 agoDon'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 agoSpecialized training, the supply of which is artificially constrained by the AMA/RUC.
- EpicEng 8y agoIs it? Genuine question, I don't know anything about that.
- smileysteve 8y agohttps://thescotandscotland.wordpress.com/2015/08/19/american-healthcare-ama-monopoly/ https://thescotandscotland.wordpress.com/2015/08/19/american...
- moorhosj 8y agoYes, 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 agoAre the CPA or CFA harder to achieve than in the past?
- moorhosj 8y agoVery 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...
- maxxxxx 8y agoJust look at their cars in the parking lot. Doctors are doing very well.
- zozbot123 8y agoAren'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.
- TheAceOfHearts 8y agoDefine "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 agoI 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.