Hospitals: Welcome to big business

Healthcare ShoppingThe article awhile back in Time on the “business” of healthcare was a wake-up call for every consumer of healthcare in the country.  It seems that more and more hospitals are becoming big corporations and even pharmacists and nurses jobs are now in jeopardy as sequestration cuts force hospitals to cut staff.  What this means for consumers and patients is longer wait times and worse service at a time when more and more people are entering the healthcare system due to aging.  We should all be concerned here because this could effect every one of us.

My brother in law has worked as a registered pharmacist for almost 19 years.  He regularly works double shifts and puts in a lot of overtime to keep the flow of meds going at his mid size hospital.  Yesterday he got a call from his boss asking if he would voluntarily take a severance package as one of the four pharmacists has to be cut due to budget cuts which are related to the sequester.   Needless to say he was devastated to get this call and now must live on the edge until his manager makes her decision later this week.  Welcome to business of healthcare.

I am not naive enough to believe that business exists for anything other than to keep it’s shareholders happy but in healthcare cuts directly or indirectly effect us all.

db’s medical rants recently posted a story from the AMA News - Will a “silent exodus” from medicine worsen doctor shortage?

Frustrated by mounting regulation, declining pay, loss of autonomy and uncertainty about the effect of health system reform, doctors are cutting back the number of hours they work and how many patients they see.

Between 2008 and 2012, the average number of hours physicians worked fell by 5.9%, from 57 hours a week to 53, and doctors saw 16.6% fewer patients, according to a survey of nearly 14,000 doctors released in September. If the trend continues through 2016, it would equate to the loss of 44,250 full-time physicians, said the report, conducted by the doctor-recruiting firm Merritt Hawkins & Associates for the Physicians Foundation. The foundation was started in 2003 with more than $30 million from class-action settlements that 22 state and county medical societies made with health plans.

“This is a silent exodus,” said Mark Smith, president of Merritt Hawkins. “Physicians are feeling extremely overtaxed, overrun and overburdened.”

So physicians too are feeling the financial pressure while some very big hospitals take in huge amount of profits.  As a great line from the movie “Wall Street” states “how much is enough?”

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Now a lot of people point the finger at high drug prices and I can’t argue with them except to note the high price of drugs is due to the increased costs to develop and drugs and get FDA approval. However a press release from the Department of Health and Human Services published this morning states that seniors have saved roughly $6 billion on prescription drugs following the closure of the infamous donut hole.

As the third anniversary of the Affordable Care Act approaches, Health and Human Services Secretary Kathleen Sebelius announced today more than 6.3 million people with Medicare saved over $6.1 billion on prescription drugs because of the health care law.

“By making prescription drugs more affordable, the Affordable Care Act is improving and promoting the best care for people with Medicare,” Secretary Sebelius said.

The Affordable Care Act makes Medicare prescription drug coverage (Part D) more affordable by gradually closing the gap in coverage where beneficiaries must pay the full cost of their prescriptions out of pocket. This gap is known as the donut hole.

Now keep in mind that the Ryan budget would repeal that so the drug industry would make more money but cost us all more.  Also keep in mind that obesity, a major driver of heart disease and type 2 diabetes, as well as many other nasty problems, accounts for 10% of all health care costs and Type 2 diabetes is a disease largely driven by lifestyle and has a cost , counting medical and indirect costs such as lost wages, of about $251,ooo for men and $180,ooo for women lifetime.  The CDC has estimated that 40% of the U.S. population is diabetic or prediabetic and that number could be 50% by 2020.  Spending on prescription medicines in the US is,and has always been,considerably less than spending on hospital care or physician services. Chronic disease accounts for $3 out of every $4 spent on healthcare.

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There is no doubt that our whole healthcare system is in the midst of some major changes but whether these changes result in higher patient satisfaction and better patient outcomes is open for debate.  When we have to go to the hospital we want what is best for us and trust our HCP’s to recommend what is best but what is best for them often results in the shocking costs of a hospital stay.  We cannot afford to stay silent anymore and everyone within the industry has to raise their voices to do what is best for patients not the balance sheet.  If we remain quiet we all could pay a huge price.

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