Wednesday, October 14, 2015
How regulations raise health care costs
There have been accusations, including some by our president, that doctors sometimes order procedures just to make a profit. For instance, that doctors are more likely to cut out tonsils, or cut off legs, or perform c-sections, because these make more money and are easier than trying to find out why the tonsils are swollen, why a leg is rotting off, or waiting for birth to be natural. The cure for this is supposed to be government run healthcare and not for profit healthcare, as these evils are the result of capitalism.
Yes, if you are a doctor and you are cutting out tonsils or cutting off legs just to make a profit than you are a despicable doctor. Still, government run healthcare will not solve this problem, only make it worse. I can give you some real life examples to make my point.
According to modern healthcare regulations, if you come to the emergency room with generic dyspnea, and the doctor even thinks you should be admitted, you will receive three breathing treatments. This is because if you don't need at least three breathing treatments you aren't sick enough to be admitted and therefore do not meet criteria for admission nor for reimbursement.
The same is true once you are admitted. One of the best ways to assure reimbursement criteria is met is to order breathing treatments on a frequency, such as Q6 or QID. This way an auditor can looking back on the patient stay will see that, "well, the patient was sick enough to need breathing treatments, so he must have been sick enough to be admitted. So we will reimburse the hospital for that patient."
Okay, so this is true whether breathing treatments are needed or not. Breathing treatments cost over $100 each, and therefore rack up quite a hefty charge. You add into this other procedures that are ordered just so the hospital meets criteria, and this adds up to a lot of money.
There's one other not anticipated aspect of Obamacare. The authors did not expect that hospitals would actually hire people to make sure the above is done. The go over charts, and when they see a diagnosis the doctor did not write would charge better, they call the doctor and tell them to write it. When they see breathing treatments aren't ordered, the call to get the order.
These Obamacare workers make a lot of money. And when you figure that over 30 of them work at every hospital, this adds to the cost of medicine. So in order to pay for all these extra workers, hospitals have to make choices. They have to cut back on the number of nurses they hire, or pay lower wages and salaries, or raise prices.
So, in this way, government healthcare raises healthcare costs, not lower them.