And now, four-star hospitals | LAT | 3.6.06
There is a couch that pulls out into a bed for family members, a carpeted floor, a flat-screen television set and a roomy bathroom stocked with plenty of plush towels and a cozy waffle-quilt bathrobe. “The rooms are bigger, the food is like eating in a fancy restaurant….There’s no comparison,” says Jack Light, 70, of Westlake Village, who had a partial knee replacement there in late 2005.
“The service at the hotel…”
Whoops. He meant to say hospital.
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Hospitals like this might be the wave of the future, providing patients with care that is highly specialized, excellent, comfortable, efficient, courteous and largely infection-free. They might also be part of an economic tsunami that flattens the revenue general hospitals need to keep their emergency rooms, trauma centers, intensive care units and medical wards open—services that no one covets, but anyone could need, at any unexpected, vulnerable moment.
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Such a threat prompted Congress, in 2003, to impose an 18-month moratorium on building more for-profit specialty hospitals. (Right now there are about 100 nationwide, including at least eight in California and one—Thousand Oaks—in Southern California.) Congress also worried that physicians referring patients to hospitals they owned could represent a conflict of interest that might affect medical care.
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They concentrate on bypass surgery, angioplasty, knee and hip replacements, stomach stapling, prostate removal and sports medicine—all of which turn a tidy profit.
None of them serve traditional money-losers for hospitals such as patients who require not procedures but extended medical care—for AIDS, cancer, diabetes or pneumonia. They don’t serve victims of violence, auto accidents, skiing mishaps and fires, none of whom are money-makers. No one is scrambling to open for-profit trauma centers or for-profit AIDS hospitals.
Instead, critics charge, these doctor entrepreneurs are skimming the cream, building palace-like facilities and referring their most healthy and profitable patients to their own hospitals. Sicker, more costly patients continue to go to community hospitals, skewing the mix of patients and putting already financially strapped local hospitals in an even deeper bind.
The California Hospital Assn., which represents the state’s 430 general hospitals, thinks destabilization is well underway. “We think [specialty hospitals] create an unfair playing field,” says association spokeswoman Jan Emerson.
Hospitals: Is the Price Right? | CBS 60 Minutes | 3.5.06
(CBS) Most Americans know that if you get sick enough to go to a hospital, it’s going to be expensive. But you may be surprised to learn that hospitals all over the country charge their highest prices, by far, to those who can afford it least—the 46 million Americans who don’t have health insurance.
Hospitals charge uninsured patients two, three, four or more times what an insurance company would pay for the same treatment. And, when the uninsured can’t pay, they often find themselves the target of collection agencies or in bankruptcy court.
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The bottom line: Forbes found that, while St. Joseph’s was billing Ferlini almost a quarter of a million dollars, it would accept just under $50,000 as full payment from an insurance company for the same treatment.
The hospital charged Ferlini more than $5,800 a day for intensive care, nearly 2½ times more than what an insurance company would pay.
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60 Minutes got a different perspective from Sen. Charles Grassley, R-Iowa. The Senate Finance Committee, which he heads, is investigating hospital charges and collection practices.
Asked how widespread the problem is with the uninsured, Sen. Grassley says, “From media reports, from advocate groups, from individuals and from my own investigation, I think it’s very, very widespread. It’s an institutional bias against uninsured people. And it’s something to be outraged about.”
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“What I’m told by the hospital association is ‘Please understand, we’re making changes. We have quote—new policies—that are dealing with this.’ Am I to believe that?” Rather asked Grassley.
“I’ve been told that they were going to do that. They’ve told me that. I haven’t seen the changes I ought to see. But if I don’t see it very, very soon, we’ll probably be doing some legislating in that area,” the senator replied.
Grassley Senate Finance Committee, on two fronts, forming a pincher maneuver on general acute hospitals. Fronts:
- Specialty hospitals and the cream skimming of general acute hospitals.
- General acute hospitals shifting the financial burden to the uninsured.
A question begging to be asked, are the uninsured, that fall into the health safety-net indirectly funding the well-insured that can, at all cost, avoid the health safety-net?