Friday, December 18, 2009

Wrong Mindset

I was doing my daily read through the web, and I found this story on MSNBC. The story is questioning the use of helicopters to transport patients. The author of the story points out that this service is very expensive and that insurance companies will only usually cover part, if any, of the 8 - 25 thousand dollar cost of the flight.

In explaining the high cost of a helicopter transport, Craig Yale, the head of a company that specializes in helicopter transport tries to explain the soaring costs of this questionably overused service. For one, Mr. Yale states that the service requires an enhanced state of readiness, which is expensive. In addition, the cost of equipment drives up the bill, not to mention the highly specialized staff who work in very challenging environments.

I'm okay with those reasons, but one additional statement that he makes in defense of the high cost I found to be ridiculous. "If a given flight costs $7,000, an ambulance operator has to charge $14,000 to make up for people who don’t pay, discounts for Medicare and Medicaid and reluctant insurers, Yale said."

I have to say this excuse to charge more money in the health care industry makes my blood boil. How is it that we've gotten to the point where we just accept the fact that we can overcharge the crap out of people to make a profit and blame the problem on people who cannot afford to pay their bills.

Another quote by an EM physician in California who runs a billing company for air transport professionals exemplifies this.
“We’ve got to collect enough money for the service, or the service goes out of business.” The article goes on to quote that this physicians company managed 500 million dollars in revenue in 2008 and 20 million in net income. I'm no expert in finance, but it doesn't sound like this company is struggling to keep the lights on.

Let's look at another example. I went on the web to find the annual report for a mega conglomerate of hospitals, Ascension Health. This corporation had revenues of $407 million. They had a net loss of $710 million in 2009, but this was due to losses that came from a poor market. In 2008, $512 million in revenue led to $356 million dollars in income. In FY 2009, the company lists over $800 million in uncompensated care. Imagine what the profit would be if everyone was paying their over-inflated bills.

I tell this story to say this - the health care industry is NOT hurting for money! Hospitals continue to build, even in this poor economy, and they aren't building double rooms with standard definition televisions. They are building private rooms with flat screen televisions, staffing the cafeteria with chefs and treating putting in applications for Michelin stars.

I'm not saying that making money is inappropriate, but I do think that it would be worthwhile to change the mindset of our industry. Maybe it's time to find a way to focus on providing quality care at reasonable prices to as many people as possible.

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