> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of jon louis mann > Sent: Sunday, May 20, 2007 11:04 PM > To: Killer Bs Discussion > Subject: U.S. health care > > "Why do we behave the way we behave? What has become of us? Where is > our soul?" > > DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's > Skid Row, sometimes dressed in only a flimsy gown and without a wheel > chair, even if they're not healthy enough to fend for themselves. > Anderson Cooper reports on the practice known as "hospital dumping."
The first thing that comes to mind is that this is an expectable, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. I have had some extended conversations with my brother-in-law (a physician who has a low income private practice in Northern Michigan (he sees a lot of Medicaid patients, and the area is very poor). We agreed that what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. The system we have now is that a hospital is not required to take any given patient (I think there are exceptions for some public hospitals such as Ben Taub in Houston). However, once a patient is in, they must be afforded the best care available...until they meet discharge criteria. This is an overwhelming cost to the hospitals, with virtually no hope of recovering the costs. Insurance companies have the leverage to bargain down bills...as anyone who has seen a hospital bill before and after adjustments can tell. So, the bills for those paying privately are through the roof...especially if they do not pre-pay an negotiated amount. For example, we got a bill for 50k for the use of an operating room, a day in intermediate care, and 2 days in a regular room.....and had to prove that we pre-paid a negotiated 12,500. The insurance rates were lower than this, of course...so the hospitals can only recoup so much of indigent care from insurance coverage for other patients. Given this, we can see why hospitals would be strongly motivated to release indigent patients that meet discharge criteria...particularly those who are candidates for extensive expensive care. While this is certainly wrong, I think the real problem is the system. And, fixing this is not as easy as Moore might suggest. As it stands, over 16% of GDP is spent on health care.....and this is with a significant fraction of Americans obtaining sub-standard care If everyone was given the BMW service, this would rise to 20% to 25% quickly. As it stands, costs are expected to rise to 20% within 10 years, which means that BMW care for all would cost 25%-30% within 10 years. There are a lot of things that can be done to address these costs, but they will involve sacrifices by average people who now have good insurance. We will have to allow, as do other countries, government bureaucrats to decide services that will be offered as well as waiting lists for non-emergency procedures. This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. Dan M. _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
