A $1500 Stitch in Time

Outrageous hospital charges are a cliché by now but impossible to ignore in the health-care debate for fear of a taking a cheap shot, something unknown in an emergency room.

“A day spent as an inpatient at an American hospital,” says a New York Times report, “costs on average more than $4,000, five times the charge in many other developed countries...The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures--closing a wound with a needle and thread--typically leads to bills of at least $1,500 and often much more.”

When I was a kid in the Great Depression, the only classmate whose family had a house rather than an apartment was a doctor’s son, but the first floor of their brownstone was his father’s offices and waiting room. It was like living over a store, except that the head of the house drove an expensive car to make house calls (in those days, doctors actually visited sick patients).

My first college summer job was in the print shop of a hospital, where the forms were for patient treatment, not charges.

All this may seem primitive and, absent today’s life-saving technology, it was. But even so, patients were treated as people, not units in a profit center.

Now, concludes the Times report: “In theory, health care consolidation can lead to economies of scale, but not if it produces complex supersize systems. Excess administrative costs accounted for about $190 billion of the $2.5 trillion medical bill of the United States in 2009, the Institute of Medicine estimated this year--money that could be used for other purposes.”

Like patient care, for example.

According to one expert, “There is a big flurry of consolidation and the effects depend on what the objective of the health care system is. If the intent is to improve care and bend cost curves, then networks can do so. If the objective is to corner the market and demand higher rates, then that will happen.” Research shows that today’s hospital mergers drive up prices.

Medical advances have led to longer and better lives for millions of Americans, but the intrusion of corporate profiteers, religious fanatics and political posturers has turned the Hippocratic Oath into Hypocritical Greed.