Tuesday Links


Narcissistic elephant paints himself.

Perhaps we could teach the Republicans in congress to do this … naaah, not smart enough …

Here’s some links from the past week or so — enjoy:

Back soon — take care, God bless.

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One thought on “Tuesday Links

  1. I finally got around to reading a couple of your links. That first one regarding not-for-profit hospitals caught my eye.

    I no longer work there, but my post-retirement job for five-plus years was in a very successful health care system that includes five hospitals, a retirement community and other assets. Having spent most of three decades in the private sector scratching to squeeze a nickle or two out of every dollar, I was amazed at the wholesale waste of resources in the “not-for-profit” sector.

    It is true that they write off millions…maybe billions of debts incurred by the community. I know personally of one woman whose husband ran up bills that would have wiped out a lifetime of thrift and responsible savings before he died of cancer, and the hospital forgave the debt so she would not be left a penniless widow. They gambled and lost when he took early retirement without adequate health insurance. I’m sure there are hundreds of similar stories to match.

    But from the inside it is clear that they do everything possible to minimize such debts while harvesting maximum revenue from insured patients. High-profile cancer and heart treatments make for big revenue streams while uninsured people wait until they get sick to seek treatment, knowing that hospitals are obliged to provide care, even if it is minimal.

    I was shocked to learn that people now call ahead to compare wait times at emergency rooms before deciding which hospital to use! I thought those places were for emergencies, but apparently they are involuntarily in the primary care business.

    There is a “fast track” system for the emergency rooms, but the operational reason is partly to triage insured patients from the uninsured in order to get the uninsured out more rapidly. I heard this from an ER nurse at a company meeting and was shocked. Likewise, if an uninsured patient says the right things when they come for treatment, there are forms to expedite the write-off… and if someone pays cash a fifty-percent discount can be arranged. These little details are not advertised because they don’t fit the image.

    As a professional, I’m sure you know a lot more about the inner workings of the system than I. But as a layman I saw lots of room for improvements in the system, starting with bills that actually reflect the costs of the service, not inflated to the threshold that the insurance companies can be squeezed to pay. Those of us who are insured are actually paying for the un-insured, and the results are poor overall. The difference, of course, is what flows into the profits of insurance companies whose mission is not providing health care, but selling systems that deselect populations most in need of that care.

    This was in the article, too…

    One reason for hospitals’ soaring profits is a gradual increase in Medicare reimbursements after federal budget cutbacks during the 1990s.

    By merging and gaining scale, many hospitals also gained leverage in price negotiations with health insurers.

    However, much of the industry’s profit growth comes from strategies it honed to increase profits. Among them: demanding upfront payments from patients; hiking list prices for procedures and services to several times their actual cost; selling patients’ debts to collection companies; focusing on expensive procedures; and issuing tax-exempt bonds and investing the proceeds in higher-yielding securities.

    I have become more cynical about the problem over the last five years than I was before. And I was cynical enough before that.

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