Hospitals run by government used to be the place where people who could not afford other health care were supposed to go for treatment. In 1986, EMTALA, the Emergency Medical Treatment and Active Labor Act, turned this system on its head. It required hospitals to provide the same kind of emergency treatment to everyone, whether or not an individual had made provisions for payment.
The problems created by EMTALA are severe. They illustrate a crucial problem in health care policy: can a health care system be stable if it requires that people who do not pay be treated in the same facilities and to the same standard as those who do?
Right now there are about 50 major U.S. hospitals actively marketing in Latin America to recruit patients. They’re already competing in an international marketplace and many are doing it with a package price structure. They are doing the things they need to do to compete effectively on quality and price in a global market.
Other things equal, the more operations a surgeon has performed, the higher the quality of his surgery. But a surgeon’s experience is still less important than the hospital system and its surgical protocols for patient mortality.
Greg Dattilo and Dave Racer are two insurance men with lots of experience and understanding of what’s right and wrong in U.S. health care. Every couple of years they write a book, and they’ve just published Why Health Care Costs So Much: The Solution – Consumers.
It’s a rare book (actually a “booklet”) about health policy that is fun to read (Top Ten Myths of American Health Care being another recent example). Plus, at 80 pages (including drawings) and available in bulk for only $1.50 each, you can buy a box and hand them out like religious tracts. Continue reading Why Health Care Costs So Much→
This is Jane Orient, MD, of Tucson, Arizona and head of Association of American Physicians and Surgeons, responding to the Cato report described here:
So just who should be my boss? What credentials? What oversight of the boss? Who gets sued if there's a problem?
The "project manager" in cases like Mr. Kling's used to be called "doctor." Seeing to all those details used to be my job when I was the attending internist rounding on my private patients in the hospital, calling the consultants but doing all the medical work outside of the specialty procedures, always looking for trouble. Continue reading Bossed to Death→
Private hospitals tend to have private rooms and lots and lots of plumbing. These features help control infections and make hospitals safer for patients. Because governments can shut down private hospitals that fail cleanliness standards, private hospitals also spend a lot on maintenance and housekeeping. Government hospitals tend to do things differently.Continue reading Hospital Infections: Does Hospital Ownership Matter?→
The company has compared results over a five-year period for 266,000 consumer directed health (CDH) plan enrollees using Health Reimbursement Arrangements (HRAs) with 147,000 preferred provider organizations (PPO) enrollees. After adjusting for demographics, health status, etc., here are the results:
Pharmacy costs were 18% to 23% lower in the CDH plans and medical costs were 4% to 8% lower.
Overall costs were 7% to 9% lower in the CDH plans, with the savings growing through time (employers saved 10% and 12% in 2006 and 2007, respectively).
He'd have paid $70,000 to have surgery at a Bay Area hospital, and $12,000 plus travel expenses to do it in India. Then he found Oklahoma Heart Hospital, which did the surgery for just $15,000. "The hospital was new, all-digital, with good food, and the doctor had done hundreds of these surgeries," he says. [link]
