4 ms·

You saw it with Covid. Trillions of dollars spent on U.S. healthcare, but hospitals are running hyper-efficient, lean staffs, with barely any ability to scale

• ed25519FUUU 4y ago
  Millions of covid relief dollars sent to states just to be vacuumed up into poorly funded city and state pensions.
• aantix 4y ago
  Wondering out loud - with non-profits, the IRS can enforce that status by forcing them to spend if they have too much money saved. Am I getting this correct? What about forcing hospitals to spend on staff if they are too profitable? I’m being purposefully vague to fill in the holes with discussion. Feel free to throw tomatoes at me if it’s a dumb idea. I’ve had dumber.
  • lowercased 4y ago
    > What about forcing hospitals to spend on staff if they are too profitable? Why do I suspect we'd see 'hollywood' accounting for medical if this ever were to be a 'thing'? 'Medical accounting' would become such a thing that we'd end up seeing every hospital running in the red all the time, to avoid this sort of thing. Someone would still be bringing in profits, but much much harder to spot.
• Zigurd 4y ago
  It's an excellent analogy: The triumph of beancounters turns out to be brittle and costly when, in this case track maintenance, unprofitable but necessary activities and capex are reduced. "It worked fine this quarter!"
  • efitz 4y ago
    I regularly see executives incentivized and rewarded for short term thinking. I never see executives pay a price for the results of years of short term thinking - they only get punished for failing to meet quarterly targets. Execs often jump around before the results of their shortsightedness bear fruit. I dream of a world where the performance of leaders and decision makers is linked with the long term performance of the organizations that they used to manage as well as the one that they currently lead.
    • btrettel 4y ago
      What are the options for incentivizing long-term performance?
      • Zigurd 4y ago
        Difficult. You need strong, diverse boards. You probably need worker representation on boards. You need a cultural change that's not very American.
    • JumpCrisscross 4y ago
      > never see executives pay a price for the results of years of short term thinking - they only get punished for failing to meet quarterly targets Are we watching the same securities filings detailing multi-year stock and cash awards based on long-term stock price and operational metrics?
• treeman79 4y ago
  Hyper efficient? MRI coats me 1500 deductible. Plus whatever they bill insurance. Cash price $750. Is really screwed up.
  • eatonphil 4y ago
    That word is being used in a different way in this case. Maybe it's an economic definition of "efficient" but I'm not sure. It means they are spending bare minimum on staff/expenses to achieve whatever goals they have. Like "lean".
  • postalrat 4y ago
    Efficient money making machines.
  • aantix 4y ago
    Meant that they're only employing the exact number of doctors/nurses to meet their current capacity. It's great for profitability, the tradeoff being when there's increased demand, it's inflexible.
  • FullyFunctional 4y ago
    Hyper efficiency isn't about you, it's for the corporation and, to no small degree, the insurance company. I'd have to imagine that the amortized cost (millions?) for the MRI machine, it's operation and storage, and the trained personnel isn't free, but obviously much less than you and your insurance pay.
  • floren 4y ago
    The sickest part is the "billed to insurance" value. You get a medical bill that looks like this: Cost: $1000 Paid by patient: $200 Billed to insurance: $800 Paid by insurance: $150 Remaining to be paid: $0 I get statements that look like this all the time, where the provider "bills" the insurance for $N, but the insurance pays a fraction of it, and apparently that's "good enough". But when they tell me "that'll be $200 today, please, we take Visa and Discover", I don't have the option to say "actually I'm gonna pay $50 and that's good enough"