Reply #16: You are correct that there would be significant savings on our employee health insurance... [View All]

[newtothegame]

And you are spot-on about the non-profit status of lots of healthcare institutions. I am 100% behind our Senator Chuck Grassley's actions to force hospitals to justify their non-profit status. We are fully able to justify our status through charity and uncompensated care and outreach. The amount we invest in these areas is far more than we would ever pay in taxes. But there are a lot of institutions that are doing a very poor job of justifying their status.
To answer your questions about the cost of an MRI going up, there are a number of factors.

1) If you are commercially insured, we are recovering our losses from Medicare/Medicaid patients through you. Unfortunate but true. Your insurer (and thus you) are subsidizing those losses. Which is why I want single-payer to be much different than just "Medicare/Medicaid for everybody." We could never afford it if everyone was reimubursed like Medicare/Medicaid patients.

2) There is pressure for hospitals to consistently upgrade to the best and brightest, even if the marginal inprovement in outcomes is less than the marginal increase in cost. This is because 1) government reimbursement is higher for some of these technologies and 2) if we don't upgrade to this equipment, our competitors will. Though we are non-profit, if our patients who can travel go to another healthcare provider (especially those who get procedures we actually make money on), we risk going out of business and the patients who can't travel will have lost their local provider. So our upgrade costs for technology are incredible.

3) The current government reimbursement structure does not account for fluctuations in the severity for illness. For instance, while commercial insurers usually reimburse us for a percentage of charges or of costs, the government reimburses us based on what they think they can afford. Problem is the severity and complications of cases vary, and while a really good case can cost as LITTLE as HALF the amount we're being reimbursed, complicated cases can cost AS MUCH AS FIVE TIMES the amount we are reimbursed. This is barely sustinable with our current percentage of Medicare/Medicaid paients; what if ALL patients were reimubursed this way?

There are obviously other pressures, including our unsustainable contract with our nurses union (previous administration's negotiation, not mine, but we are currently paying 2.5 times pay for overtime and 3.5 times pay for holidays), and I feel bad bringing that up in light of our recent conversations about the auto unions, but it's just the fact in our case. But the top 3 are huge. I'm all for single-payer healthcare, and serious HC reform, but I'm telling you there is NO WAY we could provide care if all patients were reimbursed like government patients are right now.

edited for spelling