You don’t need a doctor or a hospital or an insurance company to splint a broken arm. Get a friend with a plank and some gaffer’s tape and a pint of bourbon.
When I broke my ribs a few years ago I didn’t even bother going to the ER, because I knew that they’d do exactly the same thing I was going to do myself — strap a big Ace bandage around my chest — but charge me a couple thousand bucks to sit around waiting in a dingy plastic chair for a few hours first. If a lung got fatally punctured, well, I wouldn’t be around to bemoan my condition. So it goes.
That’s great for the generic stuff. But every so often, there are medical cases that REQUIRE the services of high-end hospitals and high-end doctors. You either get it. . . .or get a “bad outcome”, for values of “outcome”.
And suddenly. people who decide that they MUST save their child, are going bankrupt to do so.
Surprisingly, that’s not what the numbers show. Studies have been done on this over the last decade, and while I don’t have a link to them they indicate that results at the “big name” hospital are often no better than at the hospital down the street.
Sure, if a particular specialist is needed, you want to be where that specialist works. But it’s the doctor, not the hospital, that matters.
Of far greater import in terms of getting well are whether the hospital follows checklists, whether it maintains sanitation protocols in rooms and in operating theaters. Many big name hospitals don’t. Many big name doctors don’t, either.
I will agree that more studies on this question are needed, that more numbers are needed, and more transparency is needed. But based on the studies I’ve seen as a reporter, the high-priced spread doesn’t justify the high price in terms of results.
Well, that’s the whole point: on far too many of the new Obamacare plans, the only way to cut costs was to shrink the allowed provider pools to the “affordable” phyisicians.
So, as has already been the case with many cancer patients, they can’t use the hospitals OR the doctors that have been managing their care and continued survival. Likewise, if you NEED Doctor X to save you child’s life. . .but neither he nor the hospitals he practices at are in your plan. . . .You either suck it up, and pay the bill. . .or watch your child die.
We have to get costs down. You’re arguing to maintain the current,
unaffordable high cost of health care.
There should be an appeals process built into the system that would allow
people to get the care they feel they need. But when that happened in the
1990s, everyone demanded the care they WANTED, and eventually got it. Which
is how we got to the present situation.
Here is the bottom line. You can’t have an unlimited draw from a limited
pool. True for both private and public pools of money. When you argue that
people should have full control over a preference in doctors or hospitals,
you’re arguing, essentially, for an unlimited draw.
The families demanding Doctor X or Hospital Y don’t know that those doctors
or hospitals are better, because there is no transparency in either results
or pricing. We need both. Without health reform, we get neither.
And that’s what is most important – the health of the nation – not the
life of one individual. Sorry to put it so bluntly, but there it is. You
may not like it, but in demanding Doctor X and Hospital Y, at all costs,
you’re being manipulated by high-priced doctors and hospitals who don’t
want to reveal their pricing, and are thus left out of the new networks.
Indeed. The campus where I work is part of a huge hospital system with three large parking garages, and it’s always been mandated that staff must park only in the top three floors of the garages. Which are always full, and which have no street-level indicator to show usage so it’s always a crapshoot to see if any spots are left. Off-campus parking is provided with bus service every 15 minutes, but that means I’d have to ride with and speak to my fellow coworkers which is something best avoided.
This is why we need better bike lanes, among many other things.
I do wonder how much of the hospitals’ reluctance to quote numbers for procedures comes with the “my cojones are bigger than yours” game they and the insurance companies seem compelled to play with each other. It’s become expected that doctors overquote fees to insurers in order to get what they consider an acceptable amount after the insurers apply a discount and then cover only part of what’s left. And they have to assume that you may report their answer to an insurance carrier. This is not a situation in which either openness or honesty serve the hospital well.
That’s what we get for insisting upon preserving the health insurance system rather than replacing it with a health system.
(The American public gets what it deserves. I just wish I wasn’t stuck with what they deserve.)
