Why Healthcare Is Unrealistically Costly in America?
According to the American Hospital Association in 2012:
According to the American Hospital Association in 2012:
Total Number of All U.S. Registered Hospitals 5,754
Number of U.S. Community** Hospitals 4,985
Nongovernment Not-for-Profit Community Hospitals 2,904
Investor-Owned (For-Profit) Community Hospitals 1,013
State and Local Government Community Hospitals 1,068
Number of Federal Government Hospitals 213
Number of Nonfederal Psychiatric Hospitals 435
Number of Nonfederal Long-Term Care Hospitals 111
Hospital Units of Institutions (Prison Hospitals, etc.) 10
Total Staffed Beds in All U.S. Registered* Hospitals 941,995
Staffed Beds in Community Hospitals 804,943
Number of Rural Community Hospitals 1,987
Number of Urban Community Hospitals 2,998
Number of Community Hospitals in a System 2,941
Number of Community Hospitals in a Network 1,508
Total Admissions in All U.S. Hospitals 36,915,331
Admissions in Community Hospitals 35,149,427
Total Expenses for All U.S. Hospitals $750,602,099,000
Admissions in Community Hospitals 35,149,427
Total Expenses for All U.S. Hospitals $750,602,099,000
Expenses for Community Hospitals $677,968,038,000
Average cost per admission $20,333
One less hospital day and one less unnecessary test per admission can save at least about $3000/patient.
$3000 X 36,915,331 admissions = $110,745,993,000 per year. (That’s $110.745 BILLION with a B).
I am convinced that the main bulk of health care expenses comes from excessive spending, unnecessary overtesting and overtreatment. This is because of the practice of defensive commercial medicine, for fear of being sued. If physicians were more comfortable and less overworked or threatened by malpractice, it would have been possible to reduce hospital length of stay and avoid unnecessary testing, treatment, consultations, and procedures.
On average, each hospital physician has 5 hospital admissions, 5 discharges, and rounds on 10 more patients per day. If each physician avoids one needless test, consultation or saves one day of hospitalization per patient, he or she would save average $15,000 per day or $5.475 million per year!!
The style of medical practice in our country is commercialized and significantly affected by our lifestyle. Our society depends on spending and consumerism more than anywhere else in the world. We also waste too many resources, mainly because we buy more than what we need from food, cloth, cars, toys, computers, even medical procedures, and medications.
Medicine is like anything else in our society, if a bad or unexpected outcome happens, someone is to blame, and it is usually the physician who is being sued. Some patients believe medicine is a service they pay for and its purchase guarantees cure. Nevertheless, the human body and medicine never work that way. Humans are not machines.
We have a great legal system; however, it makes it very easy for lawyers to sue for unrealistic compensation based on silly foundation. Suing is advertised daily hundreds of times on TV. Statistics show that the average physician is being sued 3 times in his or her career. I know a colleague who has been sued and dismissed 3 times in less than 5 years. Very few medico-legal malpractice cases are legitimate compared to the total number. However, suing is popular and tempting since the compensation is usually in the millions of dollars for whatever silly reasons. Even patients who are treated for free sue their doctors when there is a lousy outcome instead of being grateful for the free treatment.
When a healthcare outcome is unfavorable, lawyers and patients have nothing to lose by suing doctors and hospitals, since there are no consequences when a case is dismissed. Doctors are not allowed to sue back for damage of professional reputation or loss of time and money during the trial. Like criminals on parole, doctors have to report, the circumstances and outcome of every case in every application when joining a group, a hospital or an insurance company. More than 90% of medico-legal cases are dismissed, only 1% is lost. However, doctors are punished for the rest of their career.
Most hospitals and doctors settle, even when they are not at fault, to avoid waste of valuable time, lawyers’ fees and the inconvenience of going to court for weeks, months or even years.
It is a fact, Doctors suffer immense bullying from some malpractice lawyers and patients. In training, we were taught to write our reports as if “a lawyer is looking over your shoulder to find an undocumented fact and sue you.” We Doctors, spend (waste) way more time documenting than actually examining, diagnosing, and treating patients altogether.
Some doctors are or become so paranoid about being sued that they stop using their brains or common clinical sense. Many doctors use additional expensive diagnostic tools to cover any and every possibility. MRIs, CT scans and other tests that cost billions of dollars every year are used redundantly and needlessly. Strenuous testing is used to prove the patients are healthy instead of diagnosing the specific conditions which they are designed for. It’s a fact: most MRIs and CT scan results are normal, many ER and hospital visits are without a definite diagnosis but made up ones to justify the fees.
Many hospital admissions are unnecessary and only for the reason of being “on the safe side” or more accurately “cover your behind.” The cost is astronomically incomparable to the logical or actual benefit if there were any benefit at all.
A hospital physician who manages the spending of average $60K per day, $21.900 million per year and is able to save $5.475 million per year, is only paid an average of $180K per year in salary, on-call and weekends included. In this case, the physician pay represents 0.008% of the total cost while a broker gets paid 6% of any transaction.
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