Since it appears that people will continue to use the emergency room for minor health issues even after getting health insurance, doctors and hospitals should adapt to the behavior of the people and not the other way around.
Health care is perhaps the only industry were sellers expect buyers to adapt to them, rather than accept and operate as nearly ever other industry where organizations are always adapting to the needs and preferences of consumers in a ever-changing marketplace.
Expecting people to self-triage, and then charging them a penalty (in either time or money) when they get it wrong is how it works in American healthcare today.
The current system expects the patient to know the difference between whether, for example, they have the common flu or SARS and to choose the proper doctor and facility to match exactly what they have. Is it appendicitis or just bad gas? You better know before you decide where to go to seek relief or you may wind up having to pay out of pocket for a bill five times what it should be.
While I wish the Supreme Court had ruled the other way in the Hobby Lobby case, the optimist in me (a small one to be sure) feels that all the recent talk of descending down a slippery slope where corporations will refuse to pay for health insurance policies that cover drugs and procedures that they find objectionable on religious grounds is entirely overblown. First of all, slippery slopes are rare if not nonexistent in US politics, law, culture, and business. Second, the Supreme Court merely settled one case in a narrowly defined (i.e. applicable only to the named parties in the suit), it did not change any laws or declare any laws unconstitutional, nor did it strike down the ACA birth control requirement. Third, while it set a precedent that future litigants can cite in future suits, I do not think many companies will be willing to take the time, effort, risk, legal liability, and especially the cost of denying employees drugs and medical procedures when litigation is almost sure to follow.
Most companies, I optimistically feel, will not choose to go down this road as it is hard enough to remain profitable as a company and all companies seek as few legal headaches as possible. Plus, no company will want the bad PR and its possible effect on the bottom line. The idea that a company will decide to not pay for or allow its health insurance provider to cover blood transfusions, as some are suggesting will happen, seems ludicrous. I don’t think any company will be willing to open itself up to that legal liability, nor do I think any insurance company will do so either. Really, I don’t think a health insurance company would ever consider creating a health plan that doesn’t cover blood transfusions, which are usually essential and life-saving, due to the legal liability and bad PR it would pose. I bet (and hope) that if asked to do so by a company, the health insurance company would refuse.
While the Supreme Court made a bad call, it seems unlikely it will bring on the extreme situations some are predicting. And even if a handful of companies decide to try their luck in court, that will hardly be a slippery slope and they outcome of such cases would be nowhere near assured.
Is there something fundamentally wrong with US hospitals?
First, a report comes out that US hospital prices are arbitrary and confoundingly high, then it’s discovered VA hospitals have confoundingly high wait times. In regards to prices, hospitals tend to play a shell-game and stick it to the working poor and lower middle class much like the mortgage industry did not long ago. That’s unethical of hospitals. Not only did the VA hospitals fail to meet demand, they lied about it and covered it up. Also unethical and probably illegal.
I feel it’s not off the mark to say that we need to take a close look at how hospitals are run, managed, financed, and how they pay salaries and bonuses to employees and administrators, as something seems to have gone awry in the mission hospitals have to provide healthcare to patients in an ethical manner.
Where are these hospital’s ethics and sense of purpose? Are they only concerned about money these days? Are they simply lazy? Why do they feel they aren’t accountable?
Maybe hospitals and hospital systems need to be decentralized? The idea of combining hospitals into hospital groups was to take advantage of economies of scale to lower costs. That didn’t happen. Maybe instead of having a handful of high-rise hospitals in a city or region, there should be dozens of much smaller hospitals in the same area that would be forced to compete with one another? Maybe a smaller scale would force these hospitals to be more patient-centric and to be more concerned with quality of care rather than quantity? You know, operating more in a boutique manner than in a factory manner? Perhaps a Walmart, box-store concept to hospital care simply doesn’t work? Perhaps the doctor-patient relationship needs to occur in a more intimate setting? It would seem that hospital epidemics of MERS, staph, and pneumonia could be reduced with more and smaller hospitals in a given area. The consolidated, centralized, high-rise concept did not work for public housing, perhaps it simply cannot work for hospitals as well?
So then have hospitals hit the too-big-to-fail wall?? You know that wall that financial institutions hit when they became so big and powerful and their staff so well-paid that they totally lost their focus of their position in society and in their core mission of what they provided to their clients? Maybe there’s some kind of sociological law about the size of an institution: that at a certain point an institution becomes so large that it loses its way and becomes disconnected, that staff members get stuck in a small-cog-in-a-large-machine syndrome where everyone loses sight of the mission and assumes somebody else has their eye on and is responsible for the big picture?
One of the main concerns of the anti-GMO movement is that one day GMOs will adversely affect an ecosystem or multiple ecosystems and cause havoc as they displace indigenous plants and animals. Newsflash: that has already happened, not by GMOs, but by the species Homo sapiens.
We, people, we are the super-weed, the stink bug, the Asian carp.
So perhaps we need to label all newborn children with a tattoo that reads: “WARNING: this organism poses a threat to the health of mother earth”?
Hmmm, maybe I am for treating corporations as people?
Let’s give them a social security number and tax them like workers by treating sales as salary, and taxing that income at the higher rates for wages, rather than the lower rates for profit. Plus, taxing sales will nearly eliminate “cooking the books” and make tax evasion a lot harder. Corporations will lose many tax loopholes and write-offs and write-downs, and hiding money overseas in tax shelters will be a lot harder.
The big advantage is the government will enjoy a huge influx of cash, erasing the budget deficit and making social security and medicaid/medicare solvent and able to offer greater benefits. In fact, taxes on the middle class could probably go way down, as so many more millionaire and billionaire persons would be subject to wage taxes. If one company bought another and folded the purchased company, I guess we could then even levy an estate tax.
Also, liability for corporations would go way up, so they would have to start treating their employees and the environment a whole lot better.
And I suppose that bringing criminal charges against individual corporate managers and owners would be a lot easier with the removal of the “corporate veil”.
Yes, this corporate personhood idea is worth considering very closely, by taxing them like people on the money coming in and not the money left over at the end of the month or financial quarter.
Seems a very good deal for simply allowing them to not have to cover the costs of employee birth control!
If you’re pro-life, it also partly means you’re for illegal and dangerous abortions, as they will surely result if Roe v. Wade is overturned (as this was the case before R v. W). If you are pro-life then you must add a strategy for dealing with illegal, dangerous, unregulated abortions and abortion practitioners to your platform if you are to be truly moral and to truly protect the unborn (and the mother!).