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Fed Up with Drug Companies, Hospitals Decide to Start Their Own

nytimes.com

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Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#51
post #30

Earlier quoted context omitted.

Any source, example, etc.? Your comment reads like one of those click-bait advertisements.

UPMC. It's both an insurance company, and a chain of hospitals. And Dr.'s offices, and well, pretty much everything. Not sure which came first though, hospital or insurance company.

The MC is for Medical Center.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#52
post #46

Earlier quoted context omitted.

Good Lord, people truly just don't get it. Hospitals are not evil; they are tasked with saving people's lives. People who nobody else can save. All the worst medical problems in the world--sometimes sudden trauma, sometimes a festering problem left to burst--they all end up on the doorstep of the hospitals, full of doctors, nurses, and technicians who are humans just like you and me. And they work ridiculous hours sa…

All you are saying is correct but you can't excuse their billing practices.

Blaming one specific part of a profit-centric health care system for being profit-centric seems a little silly

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#53
post #46

Earlier quoted context omitted.

All you are saying is correct but you can't excuse their billing practices.

Blaming one specific part of a profit-centric health care system for being profit-centric seems a little silly

This is not about profit but about being opaque and dishonest in their business practices.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#54

Let's say they succeed in launching a new generics company. Ten years down the line they will divest in order to build each hospital a shiny new geriatrics wing. Within six months the spun-off drug company will jack up prices and the cycle will continue.

That would be an interesting cycle. Perhaps the hospitals could document the process of setting up the drugs company, so that as soon as the prices are jacked up, they can start up another one. It could be quite a profitable business model: starting up and selling drugs companies.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#55
post #32

Let's say they succeed in launching a new generics company. Ten years down the line they will divest in order to build each hospital a shiny new geriatrics wing. Within six months the spun-off drug company will jack up prices and the cycle will continue.

From that perspective, does any country have their own publicly owned pharmaceutical manufacturer? It's the kind of thing the NHS should do, since they control most other aspects of health care, but I don't think they do. There's so little benefit to competition with generics, you may as well have that vertical integration to at least provide what hospitals need.

Country-owned means of production have usually not fared well vs competitive forces in the past. And it could be considered as unfair competition: a state-owned manufacturer could basically have a blank check from the government for any kind of investment and would not have to worry at all about profitability. It sounds very nice as a thought exercise, but economical incentives are very tightly linked with productivity.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#56
post #46

Earlier quoted context omitted.

Good Lord, people truly just don't get it. Hospitals are not evil; they are tasked with saving people's lives. People who nobody else can save. All the worst medical problems in the world--sometimes sudden trauma, sometimes a festering problem left to burst--they all end up on the doorstep of the hospitals, full of doctors, nurses, and technicians who are humans just like you and me. And they work ridiculous hours sa…

All you are saying is correct but you can't excuse their billing practices.

I work for a hospital and I agree with you that the billing practices are shitty, but I couldn't tell you what a procedure will cost you even if ordered to. At best I could give you an average for a procedure but if you're in for a few days you may see dozens of doctors and have hundreds of procedures including an operating room procedure or two and a whole lot of blood tests, imaging, poking and prodding (e.g. assessing your risk of pressure ulcers). Each of these has a base cost and then each insurance company has a different amount they're willing to cover of that base cost and an discount rate that varies by company. Many of these factors will also depend on your personal history of diagnosis and treatment.

It's a big mess and I don't see billing practices improving significantly until the reimbursement system changes. Single payer could really simplify things for the end user.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#57
post #2

I am not sure if patients will see any of the savings though. I view hospitals as fundamentally dishonest organizations after a few experiences. Their medical treatment is fine but their financial practices are borderline fraudulent.

You'd be hard-pressed to make a system that keeps hospitals from being abusive. Your BATNA to accepting their terms is literally dying, and especially the older folks who need more care have giant piles of cash. The cynical profit-maximizer in that position will raise uninsured prices high until the losses due to "eff this, I'm declaring bankruptcy and my various creditors can squabble over my assets" outweighs the increased collection from payment plans.

62% of bankruptcies in the US are caused by medical debt.

The only saving grace in this all is that you can save enough for retirement in creditor-protected retirement accounts, and can otherwise secure yourself financially while telling your creditors to pound sand if they're being ridiculous.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#58
post #2

I am not sure if patients will see any of the savings though. I view hospitals as fundamentally dishonest organizations after a few experiences. Their medical treatment is fine but their financial practices are borderline fraudulent.

Some, if not most, of this is a result of the insurance system. The insurance companies only pay x% of any given item, therefore the hospitals have to jack prices through the roof to collect enough to survive. The problem with our healthcare system is that too much money goes to drug companies, medical device makers, and insurance companies and not enough makes it to the people actually providing the care. Its a bit…

> The problem with our healthcare system is that too much money goes to drug companies,

Erm no, actually you pay a lot more for pure hospital services all things considered than whatever is paid for the price of drugs. I totally agree that drugs should be cheaper for patients, but pretending drug manufacturers are the only/main problem is just far from the reality of the market. Every intermediate is inflating their prices as well.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#59
post #16

Earlier quoted context omitted.

Any source, example, etc.? Your comment reads like one of those click-bait advertisements.

It's really not click bait. Kaiser Permanente already operates under that model with a single organization acting as an insurer and owning hospitals. Other payers are moving in the same direction by acquiring or creating provider organizations. In some markets all of the major providers have merged together in order to gain more negotiating power so the only way payers can get some leverage back is by having provider…

Kaiser only operates in this manner in certain of the 8 regions they service. Mostly on the west coast. In the regions on the east coast Kaiser contracts with existing hospitals.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#60

Earlier quoted context omitted.

If Medicare rates are actually below cogs, why do hospitals accept Medicare patients? I know some don't, but the vast majority do. Something about that explanation feels off.

If you serve a certain rate of medicare patients, you get additional funding. It's set up this way for 'political' reasons. Like most of us politics, it's a mess.

> If you serve a certain rate of medicare patients, you get additional funding. It's set up this way for 'political' reasons. Like most of us politics, it's a mess.

That's not an incentive for hospitals to serve Medicare patients; it's compensation for the fact that the hospital sees so many Medicare patients (and therefore so few privately-insured patients, by portion) that it can't make up the difference solely from overcharging private insurers.

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