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Tuesday, April 27, 2010

CNN Special Report: Secrets of the High Cost of Medicine…

Sanjay Gupta, CNN’s surgeon/reporter takes on this topic in a special seqment tonight on CNN . I will be curious to see if he shines a light on the changes in reimbursement from insurance companies and Medicare to hospitals. The outlay of dollars to healthcare overall has not changed proprotionately as the poplulation continues to age – but who the dollars are going to has. More and more of those dollars are going directly to hospitals. Hospitals are gobbling up more of their share of the healthcare dollar. If I extrapololate what is happening in other hospital systems from what is going on in ours locally, the argument can be made that the increasing costs have nothing to do with increasing payments to those providing the care: ie nurses and doctors. The costs are directly related to so-called administrative costs: layers and layers of Corporate Executives, Vice Presidents, Senior Managers, and Department Managers . Even in the smaller private hospitals, the layers of administration are mind-boggling.

Add to that a “government worker” mentality in every facet of operation as hospital system’s get larger and larger. And by that I mean a growing bureaurcracy that breeds inefficiency and waste – in direct opposition to the idea that economies of scale improve cost efficiency and production.

For example, a new part time stafffer assisted in an office based surgical procedure. When our office manager went in the room to prep for the next procedure, several open but unused packets of sterile gauze and needles lay open on the table. She asked the medical assistant why they had been opened. Her reply was that the supplies were opened so they would be ready to use. This is hospital mentality.: open extra, throw away the unused. Instead of : open only when needed. The new staffer had been employed at the hospital and this was standard procedure, allbeit wasteful and expensive.

The high cost of medicine is due in large part to the extreme waste of resources, aa well as what I would deem a misallocation of resources. We don’t need more administrators – we need better compensated nurses. We don’t need more rules and regulations and charting for nurses to comply with, we need more nurses to focus their time on patient care. But that’s another discussion for another day.

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