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Hospital Scam

Jun 16, 2019 | Healthcare

Ever wonder how hospitals ever deviated so far from their stated goal of helping the sick? So do we. Particularly after a staffer’s experience with Dignity Health. A review of America’s disconcerting healthcare trends is enough to make you spit up your hospital dinner. It’s high time that healthcare is disrupted

This summer, we experienced firsthand what a scam America’s hospitals have become. In July, one of our staffers skidded off his bicycle. He decided to visit St. Rose San Martin’s emergency room, a local Las Vegas hospital. Total bill for a 90-minute wait and 30-minute exam? A whopping $3,094, excluding x-ray charges.

The staffer’s insurance company, Anthem Blue Cross, elected to cover about $600 of the bill. After several complaint letters and calls went ignored, he once again called St. Rose. The answering system announced that wait time was four minutes, then, after offering a call back, the system ignored the request and upped the wait to seven minutes.

After another attempt for a call back, the wait time went to 11 minutes. In other words, St. Rose’s answering system simply ignored callback requests.

So he decided to try St. Rose’s site. That turned out to be another quagmire. The “business office” link mentioned on the bill linked to Dignity Health’s main site. Clicking on “Contact Us” simply redisplayed the home page. Check out this farce for yourself.

In America we colloquially call this experience a “cluster fudge.” And that’s the best way to describe America’s acutely ill hospital system:

No Price Comparability

The New York Times reports that a hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945.

In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while in Orange Park, Fla. the charge was $91,000. In Dallas, the average bill for treating simple pneumonia was $14,610 at one hospital, while another charged more than $38,000.

No Common Sense

Then there’s San Francisco’s California Pacific Medical Center, where stitches and glue use unobtainium. When 26-year-old Deepika Singh gashed her knee at a backyard barbecue, and a toddler at the same gathering fell from a couch, cutting her forehead on a table, they visited California Pacific’s emergency room.

Singh’s three stitches cost $2,229, while Orla’s forehead was sealed with a dab of skin glue for $1,696. If hospitals were a business competing for customers, this would never happen.

No Respect for Authority

Government data released for the first time shows that hospitals also charge Medicare wildly differing amounts, sometimes 10 to 20 times what Medicare typically reimburses, for the same procedure, raising questions about how hospitals determine prices and why they vary so much.

University of Southern California’s Keck Hospital charged, on average, $123,885, for a major artificial joint replacement, six times the average amount Medicare reimburses for the procedure and a rate significantly higher than the average for other Los Angeles area hospitals.

“Academic medical centers have a higher cost structure, and higher acuity patients who suffer from many health complications,” was Keck’s response. The hospital added that it wrote off any difference between what it charged and what Medicare paid, rather than seeking to collect it from patients. But Centinela Hospital Medical Center, also in Los Angeles and owned by Prime Healthcare Services, charged even more, $220,881, for the same procedure.

No Productivity

If that’s not enough to make you push away your congealed Jello, this should do it. U.S. hospitals absorb an estimated $8.3 billion annually in lost productivity and increased patient discharge times, according to a Ponemon Institute survey of 577 health care professionals.

One reason is that U.S. physicians and hospitals are in the digital dark ages when it comes to using the latest mobile devices and internet services to deliver patient care. According to Doximity CEO Jeff Tangney, “fax machines are the lingua franca of healthcare,” with 15 billion fax pages sent in the U.S. every year.

The entire U.S. healthcare sector is bereft of true competition and characterized by inefficiency:

  • Health spending – The U.S. spends $2.8 trillion each year on healthcare. That’s equal to one-sixth of the total economy or more than $8,500 per person — far exceeding any other country:

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  • Unit pricing – Part of the problem is the U.S. cost per unit of healthcare. From prescription drugs to imaging scans, nearly everything costs more in America. For example, the heartburn medication Nexium costs $215 in the U.S. and just $23 in the Netherlands:

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  • Sources of waste – There’s much waste in healthcare. The Institute of Medicine estimates that $210 billion is spent on unneeded medicine but that’s just a sliver of the $765 billion wasted annually:

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To gain more perspective on these sickening trends, read this Vox article: “8 facts that explain what’s wrong with American health care.” Suffice it to say that there’s no dignity in healthcare. Could Pope Francis help Dignity regain its dignity?

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