11 ms·

HOSPITALS: “High-markup” hospitals are overwhelmingly for-profit, located in large metropolitan areas and have the worst patient outcomes https://www.uclahealth

by nabla9 1y ago

HOSPITALS: “High-markup” hospitals are overwhelmingly for-profit, located in large metropolitan areas and have the worst patient outcomes https://www.uclahealth.org/news/release/high-markup-hospitals-are-overwhelmingly-profit-located https://www.uclahealth.org/news/release/high-markup-hospital... >These “high-markup hospitals” (HMH), which comprised about 10% of the total the researchers examined, charged up to 17 times the true cost of care. By contrast, markups at other hospitals were an average of three times the cost of care. >They also have significantly worse patient outcomes compared with lower-cost hospitals, new UCLA research finds. NURSING HOMES: Owner Incentives and Performance in Healthcare: Private Equity in Nursing Homes ( https://www.nber.org/papers/w28474 https://www.nber.org/papers/w28474 >After instrumenting for the patient-nursing home match, we recover a local average treatment eﬀect on mortality of 11%. Declines in measures of patient well-being, nurse staﬃng, and compliance with care standards help to explain the mortality eﬀect.

gjgtcbkj 1y ago
I wonder if we will be allowed to share this information in the future in someone knew a love one died in for profit hospital that might provoke violence against feel market believers.
- overfeed 1y ago
  Isn't trading higher profit for +11% more deaths also violence?
  - immibis 1y ago
    No, only direct fist-on-face contact is violence. Indirect violence doesn't exist.
  - tptacek 1y ago
    To the extent it is, people are universally guilty of it, unless you can find a clear bright line for which selfish(/rational) decisions are violent and which aren't. Is it some number of hops from the person who dies that makes the difference?
    - SpaceNoodled 1y ago
      There's a clear chain of responsibility.
      - tptacek 1y ago
        That's just begging the question. What's the clear chain?
        SpaceNoodled 1y ago
        Do you think that these policies just appear out of thin air, and enforce themselves?
    - keybored 1y ago
      We are all guilty of living in our own society? No, some people are hundreds of times more responsible.
      - potato3732842 1y ago
        I wonder why your opinion is so unpopular around here. Surely the hapless landscaper is substantially less responsible for any violence, death, etc, etc, he benefits from than say a lobbyist who gets paid to get the laws to favor his employer. We don't need to figure out an exact formula in order to be able to conclude some parties leverage violence far more than others.
    - overfeed 1y ago
      > To the extent it is, people are universally guilty of it, unless you can find a clear bright line for which selfish(/rational) We all ingest some level of arsenic, and are "universally" exposed to radioactivity, but just because something is falls on a continuous spectrum, doesn't mean all levels are equal, there is a point where it becomes too much. That point will not be the same for everyone, but it exists. > Is it some number of hops from the person who dies that makes the difference? Not according to the Nuremberg trials.
  - bcrosby95 1y ago
    I wouldn't call it violence, but I think it's A Problem when companies have two viable policies, and they choose the one that is known by them to statistically cause more deaths. On top of that, people will give them social cover for making this decision. Because, y'know, its just capitalism/business or whatever. It's not like they murdered someone, they just told their worker bees to do something they knew would kill more people than they had to.
  - Aurornis 1y ago
    > Isn't trading higher profit for +11% more deaths also violence? I have a friend who firmly believes that speed limits higher than 50MPH are violence because they lead to increased deaths. He argues that if we cared about people's lives we would impose a strict 50MPH limit on the roads and even force all cars to top out at 50MPH from the factory. There are millions of tradeoffs in the world where we could reduce deaths, but there's never and endpoint where it's truly done. It's really easy to imagine revenge on PE firms by crushing their profits for a noble cause, but the conversation becomes a lot murkier when the impact starts hitting closer to your own paycheck or lifestyle.
    - Muromec 1y ago
      In residential area it is at the very least negligence on the part of authorities who set the limit
      - Aurornis 1y ago
        The claim was that 50mph should be the highest limit anywhere, including freeways. Combined with a hard 50mph limit imposed on vehicles. You buy a new car, it can't go faster than 50mph, period. The movement has roots in Ralph Nader going back to the 50s https://nader.org/1970/12/11/the-american-automobile-designed-for-death/ https://nader.org/1970/12/11/the-american-automobile-designe...
        Muromec 1y ago
        That's a little bit out there if taken out of context. On my street the limit is 15 KM/h, on most city roads it's 30 (again, KM/h, not MPH), but on the actual highways where only cars are present and where you don't necessarily need to be, the limit is over a 100. Now I can probably understand how one can take such radical position, when living in a place that doesn't restrict cars as much as they are restricted here. It's like being so much disillusioned with US that USSR propaganda starts to be appealing and belieaveble. I guess?
        1y ago
  - MSFT_Edging 1y ago
    I think the replies splitting hairs on what is violence and what isn't is missing the point. This is a hospital. A building designed for differentiating life and death and(hopefully) attempting to steer towards the former. This isn't a speed limit or some other market where there's no ethical consumption. One doesn't choose going to a hospital. It's a place you go when you are at metaphorical gunpoint.
giancarlostoro 1y ago
And I am sure the nurses are overworked and not receiving competitive pay to boot.
- pure_ambition 1y ago
  Speaking from experience, the only people who can afford to live as nursing home staff (typically LPNs) are the poor. In my metro area, only the presence of a large low-income high-crime area allows for a low enough cost of living for its residents to survive on nursing home pay. I think these folks can make more working at McDonalds. The quality of care is garbage... Less than 10% of nursing homes in my area provide the care I'd want for my relatives. Oddly enough, even homes that advertise RNs and a high number of staff still don't provide the care I'd want for me relatives. The only homes I've been to where the staff are genuinely great are nursing homes out in the boonies, in rural areas at least an hour outside of my city.
  - trenning 1y ago
    I can echo this statement. My mother is in a nursing home facility for the last 8 years. She is located in the facility she worked in as a poor laborer before becoming a resident. The facility is over an hour from the nearest metro area. The care she receives there is pretty good. The staff are mostly locals in the rural town and are comfortable being poor and living that life. We considered moving her into the city to be close to family who have to drive almost 3 hours to see her but the care is so bad in the city it isn’t worth it. We have had family members in city nursing homes and they’re abysmal. Which to some level I get. The people there like you stated are underpaid and overworked. They live in bad neighborhoods because of systemic poverty. They bring all the stress of being poor in a metro city with them to work. Quality of care plummets but there’s nothing that can be done because no one is going to pay more than bare minimum to reach mandatory staff minimums.
    - adolph 1y ago
      > locals in the rural town and are comfortable being poor and living that life > all the stress of being poor in a metro city Is it generally accepted that people in similar economic circumstances have improved life satisfaction in rural areas? It is counterintuitive to me given any city typically has better low cost amenities like museums, libraries, and parks than rural areas that I have observed.
insane_dreamer 1y ago
For-profit hospitals, like for-profit prisons, should be banned. They create perverse incentives.
- ivape 1y ago
  This is an impossible argument to make in America because the mindshare and persuasion behind the idea that free markets are best have clouded all humane judgement. We have to move the argument to “this is an illegal business”. The Right is an amalgamation of extreme Libertarianism and race-centric Nationalism currently, and making a persuasive argument to them requires breaking everything they think they know about what is “good” in the world. I say this with respect to actually politically reshaping the discourse dynamic (it has to start at debate). The Right is the obstacle to solving this, not the Left. This is not a universal issue, it’s only a universal issue for people to politely agree and get along, but all actionable items are against the ideology of the Right. To put it simply, to get to where we need to get, we have to chisel and whither away their narratives and mindshare in debate, they skate freely on this topic. Their stance and narrative actually have no place in a problem-solving environment (we can’t solve it if the underlying ideology holds free markets paramount, over humanity).
  - tptacek 1y ago
    Most American hospitals are nonprofits and all of them operate in the free market.
    - ivape 1y ago
      What’s your point?
      - tptacek 1y ago
        That a market setting and the non-profit status of market actors are orthogonal issues.
    - FireBeyond 1y ago
andai 1y ago
17x. Jesus. Is the list of such places public? Sounds like very important information for people who need medical care. (Which is... everyone?)
- blackjack_ 1y ago
  I was charged $6000 for literally walking into the ER of a hospital in 2022 when I had covid and was having trouble breathing. This did not include the 20 mins of tests they ran for me before telling me I was fine and booting me out within the hour, those were billed seperately. Literally just the cost of using the ER was $6000 (this was the adjusted price after insurance), in addition to anything else. As you can tell from this comment, I'm still mad about it.
  - mgkimsal 1y ago
    similar. i guess i got a bargain cause I got 2.5 hours in ER with a couple tests for only $4k! Adjusted down to .. $2300 after 'insurance' (which I was paying $500/month for, with a $7k deductible).
  - mancerayder 1y ago
    Which state is this? I've gotten lucky with my insurance, expecting big bills. But I think some state laws are stricter than others when it comes to Surprise Billing. Was your hospital in network?
    - blackjack_ 1y ago
      This was in California (greater Bay Area), and the hospital was in network, but some of the ER physicians ended up not being (not the source of this part of the bill). I had a high deductible plan (10k IIRC?) so that I could stock away cash in an HSA every month. I've since switched to a much lower deductible plan in case I needed to go to the ER again, but then I also to another county and have gotten much more reasonable bills at the hospital near me.
- saalweachter 1y ago
brightball 1y ago
We were better off when the churches ran the hospitals.
- kulahan 1y ago
  The Catholic Church is still the largest non-governmental provider of healthcare in the world.
- astroflection 1y ago
  We'd be better of if heathcare was never provided for profit.
- bell-cot 1y ago
  Careful what you wish for. The two major hospitals in my area are run by (1) the Catholic Church, and (2) the local major research university. While I'm sure they could get worse, if PE took over - I've got friends and family who received disastrously poor care at both of 'em. And neither hospital ever cared about that.
  - port11 1y ago
    Could you be from Leuven? I think our second-hospital is or was Catholic Church-owned.
    - bell-cot 1y ago
      Michigan, USA.

by nabla9 1y ago

gjgtcbkj 1y ago

I wonder if we will be allowed to share this information in the future in someone knew a love one died in for profit hospital that might provoke violence against feel market believers.

overfeed 1y ago
Isn't trading higher profit for +11% more deaths also violence?
- immibis 1y ago
  No, only direct fist-on-face contact is violence. Indirect violence doesn't exist.
- tptacek 1y ago
  To the extent it is, people are universally guilty of it, unless you can find a clear bright line for which selfish(/rational) decisions are violent and which aren't. Is it some number of hops from the person who dies that makes the difference?
  - SpaceNoodled 1y ago
    There's a clear chain of responsibility.
    - tptacek 1y ago
      That's just begging the question. What's the clear chain?
      - SpaceNoodled 1y ago
        Do you think that these policies just appear out of thin air, and enforce themselves?
  - keybored 1y ago
    We are all guilty of living in our own society? No, some people are hundreds of times more responsible.
    - potato3732842 1y ago
      I wonder why your opinion is so unpopular around here. Surely the hapless landscaper is substantially less responsible for any violence, death, etc, etc, he benefits from than say a lobbyist who gets paid to get the laws to favor his employer. We don't need to figure out an exact formula in order to be able to conclude some parties leverage violence far more than others.
  - overfeed 1y ago
    > To the extent it is, people are universally guilty of it, unless you can find a clear bright line for which selfish(/rational) We all ingest some level of arsenic, and are "universally" exposed to radioactivity, but just because something is falls on a continuous spectrum, doesn't mean all levels are equal, there is a point where it becomes too much. That point will not be the same for everyone, but it exists. > Is it some number of hops from the person who dies that makes the difference? Not according to the Nuremberg trials.
- bcrosby95 1y ago
  I wouldn't call it violence, but I think it's A Problem when companies have two viable policies, and they choose the one that is known by them to statistically cause more deaths. On top of that, people will give them social cover for making this decision. Because, y'know, its just capitalism/business or whatever. It's not like they murdered someone, they just told their worker bees to do something they knew would kill more people than they had to.
- Aurornis 1y ago
  > Isn't trading higher profit for +11% more deaths also violence? I have a friend who firmly believes that speed limits higher than 50MPH are violence because they lead to increased deaths. He argues that if we cared about people's lives we would impose a strict 50MPH limit on the roads and even force all cars to top out at 50MPH from the factory. There are millions of tradeoffs in the world where we could reduce deaths, but there's never and endpoint where it's truly done. It's really easy to imagine revenge on PE firms by crushing their profits for a noble cause, but the conversation becomes a lot murkier when the impact starts hitting closer to your own paycheck or lifestyle.
  - Muromec 1y ago
    In residential area it is at the very least negligence on the part of authorities who set the limit
    - Aurornis 1y ago
      The claim was that 50mph should be the highest limit anywhere, including freeways. Combined with a hard 50mph limit imposed on vehicles. You buy a new car, it can't go faster than 50mph, period. The movement has roots in Ralph Nader going back to the 50s https://nader.org/1970/12/11/the-american-automobile-designed-for-death/ https://nader.org/1970/12/11/the-american-automobile-designe...
      - Muromec 1y ago
        That's a little bit out there if taken out of context. On my street the limit is 15 KM/h, on most city roads it's 30 (again, KM/h, not MPH), but on the actual highways where only cars are present and where you don't necessarily need to be, the limit is over a 100. Now I can probably understand how one can take such radical position, when living in a place that doesn't restrict cars as much as they are restricted here. It's like being so much disillusioned with US that USSR propaganda starts to be appealing and belieaveble. I guess?
        1y ago
- MSFT_Edging 1y ago
  I think the replies splitting hairs on what is violence and what isn't is missing the point. This is a hospital. A building designed for differentiating life and death and(hopefully) attempting to steer towards the former. This isn't a speed limit or some other market where there's no ethical consumption. One doesn't choose going to a hospital. It's a place you go when you are at metaphorical gunpoint.

giancarlostoro 1y ago

And I am sure the nurses are overworked and not receiving competitive pay to boot.

pure_ambition 1y ago
Speaking from experience, the only people who can afford to live as nursing home staff (typically LPNs) are the poor. In my metro area, only the presence of a large low-income high-crime area allows for a low enough cost of living for its residents to survive on nursing home pay. I think these folks can make more working at McDonalds. The quality of care is garbage... Less than 10% of nursing homes in my area provide the care I'd want for my relatives. Oddly enough, even homes that advertise RNs and a high number of staff still don't provide the care I'd want for me relatives. The only homes I've been to where the staff are genuinely great are nursing homes out in the boonies, in rural areas at least an hour outside of my city.
- trenning 1y ago
  I can echo this statement. My mother is in a nursing home facility for the last 8 years. She is located in the facility she worked in as a poor laborer before becoming a resident. The facility is over an hour from the nearest metro area. The care she receives there is pretty good. The staff are mostly locals in the rural town and are comfortable being poor and living that life. We considered moving her into the city to be close to family who have to drive almost 3 hours to see her but the care is so bad in the city it isn’t worth it. We have had family members in city nursing homes and they’re abysmal. Which to some level I get. The people there like you stated are underpaid and overworked. They live in bad neighborhoods because of systemic poverty. They bring all the stress of being poor in a metro city with them to work. Quality of care plummets but there’s nothing that can be done because no one is going to pay more than bare minimum to reach mandatory staff minimums.
  - adolph 1y ago
    > locals in the rural town and are comfortable being poor and living that life > all the stress of being poor in a metro city Is it generally accepted that people in similar economic circumstances have improved life satisfaction in rural areas? It is counterintuitive to me given any city typically has better low cost amenities like museums, libraries, and parks than rural areas that I have observed.

insane_dreamer 1y ago

For-profit hospitals, like for-profit prisons, should be banned. They create perverse incentives.

ivape 1y ago
This is an impossible argument to make in America because the mindshare and persuasion behind the idea that free markets are best have clouded all humane judgement. We have to move the argument to “this is an illegal business”. The Right is an amalgamation of extreme Libertarianism and race-centric Nationalism currently, and making a persuasive argument to them requires breaking everything they think they know about what is “good” in the world. I say this with respect to actually politically reshaping the discourse dynamic (it has to start at debate). The Right is the obstacle to solving this, not the Left. This is not a universal issue, it’s only a universal issue for people to politely agree and get along, but all actionable items are against the ideology of the Right. To put it simply, to get to where we need to get, we have to chisel and whither away their narratives and mindshare in debate, they skate freely on this topic. Their stance and narrative actually have no place in a problem-solving environment (we can’t solve it if the underlying ideology holds free markets paramount, over humanity).
- tptacek 1y ago
  Most American hospitals are nonprofits and all of them operate in the free market.
  - ivape 1y ago
    What’s your point?
    - tptacek 1y ago
      That a market setting and the non-profit status of market actors are orthogonal issues.
  - FireBeyond 1y ago

andai 1y ago

17x. Jesus. Is the list of such places public? Sounds like very important information for people who need medical care. (Which is... everyone?)

blackjack_ 1y ago
I was charged $6000 for literally walking into the ER of a hospital in 2022 when I had covid and was having trouble breathing. This did not include the 20 mins of tests they ran for me before telling me I was fine and booting me out within the hour, those were billed seperately. Literally just the cost of using the ER was $6000 (this was the adjusted price after insurance), in addition to anything else. As you can tell from this comment, I'm still mad about it.
- mgkimsal 1y ago
  similar. i guess i got a bargain cause I got 2.5 hours in ER with a couple tests for only $4k! Adjusted down to .. $2300 after 'insurance' (which I was paying $500/month for, with a $7k deductible).
- mancerayder 1y ago
  Which state is this? I've gotten lucky with my insurance, expecting big bills. But I think some state laws are stricter than others when it comes to Surprise Billing. Was your hospital in network?
  - blackjack_ 1y ago
    This was in California (greater Bay Area), and the hospital was in network, but some of the ER physicians ended up not being (not the source of this part of the bill). I had a high deductible plan (10k IIRC?) so that I could stock away cash in an HSA every month. I've since switched to a much lower deductible plan in case I needed to go to the ER again, but then I also to another county and have gotten much more reasonable bills at the hospital near me.
saalweachter 1y ago

brightball 1y ago

We were better off when the churches ran the hospitals.

kulahan 1y ago
The Catholic Church is still the largest non-governmental provider of healthcare in the world.
astroflection 1y ago
We'd be better of if heathcare was never provided for profit.
bell-cot 1y ago
Careful what you wish for. The two major hospitals in my area are run by (1) the Catholic Church, and (2) the local major research university. While I'm sure they could get worse, if PE took over - I've got friends and family who received disastrously poor care at both of 'em. And neither hospital ever cared about that.
- port11 1y ago
  Could you be from Leuven? I think our second-hospital is or was Catholic Church-owned.
  - bell-cot 1y ago
    Michigan, USA.