Hospitals confuse me
Richard Fulton
It is clear to me that the system by which America provides health care to its citizens is nothing short of screwed up.
The list of things to be confused about within this system is endless. Therefore, I cannot hope to touch upon them all without writing a book length exposition. And that has already been done by folks coming from the left of our political spectrum as well as those coming from the right.
Therefore, all I can do is set down some of the things that make me wonder within our own market for hospitals and doctors. You have no doubt noticed that in the last decade or two “local” hospitals have come to establish local monopolies of services.
What I mean by that is the consolidation of all doctors into the local hospital’s organization. Particularly rural hospitals but those like Mosaic as well. There are no individual doctors, they all have to be connected to—even paid by—the hospital. This creates a local monopoly on rules and regulations for all doctors to follow. And no competition over costs of services.
It has produced a singular system of costs and billing. No competition. Community hospitals like St. Francis in Maryville and Mosaic in St. Joseph control the local market. To be sure, one can take the inconvenience to go to Mosaic doctors if you are in Maryville, but emergencies don’t wait for choice and cost prohibits those with fewer resources.
Some referral happens, even consultation with Mayo by Mosaic, but this is for specialized problems.
The billing by hospitals has come under some scrutiny lately. Financing is complex for the health industry. Our local “non-profit” hospitals depend upon various income flows. The federal programs of Medicare, Medicaid and other programs to bolster the health of individuals provides a great deal of cash. Also, of paperwork.
Trying to understand the bill from hospitals may be dangerous to your health. Who pays what to who? All seems to go through the hospital regardless of the cost assigned to doctors for various services.
I had a bill that gave the costs broken down, though confusing, by procedure, etc. Then the cost was divided between insurance, Medicare, and my costs. Trouble was, if I understood the bill, the cost to the hospital and doctors was less than billed to the federal government. Why the bonus to the hospital? Beats me.
And one wonders why health care is so expensive for government and for us.
Mosaic and its predecessor has never, in the last thirty years, been without a building project. Note the new $20 million for a downtown presence. Satellite sites are a good thing, but how do they pay for all that?
Mosaic defended itself against its lead in Missouri in taking wages from those unable to pay their bills, they complain of huge losses. Yet, they have lots of money to spend. What’s the deal?
There are answers to all these questions I’m sure; so why don’t hospitals stop spending to compete with each other? If there are too many resources spent on overlapping machines and services maybe they should share rather than compete and spend more informing us why they do what they do.
I’m just saying.
