Medical care in America is a false economy driven by artificial facilities and equipment restrictions, a health insurance structure that places little focus on preventative care and cost containment, a lack of standardized and transparent pricing, and a fee for service cost structure that encourages providing more services than are necessary.
Too many Americans feel their interactions with the medical care system is a process of simply opening one’s wallet and letting them dive in. No other fee-based service separates the consumer from the pricing structure. If the service does not prove effective, the solution is to simply throw more medical procedures at the problem, generating more fees. Efficacy, short-term and long-term, is seldom tracked and cost effective approaches are rarely considered.
Nowhere is this more obvious than the most recent revelations published in last Sunday’s Juneau Empire, “Former Bartlett execs paid nearly $300k in severance.” The Board of Directors seem to think that inflated salaries and more than generous benefits equate with high quality management.
The false economy of heath care inflates costs, including salaries — which we all pay.
Many Americans are unaware of the health care Certificate of Need process that is supposed to restrain health care facility costs and coordinates planning of new services. Alaska has such a process, which requires that communities obtain this certificate prior to expansion.
I was once a supporter of the Certificate of Need process, but no longer. This process restricts services and choice and impedes competition, frequently making small communities fully dependent upon a single local community hospital.
The recent hospital management resignations and substantial severance pay reflect the false economy of the medical care industry. It is not just medical fees that are inflated. The inflation includes prescriptions, professional services, medical equipment, medical software and salaries — especially the salaries of upper level health care administrators.
My opinion is reinforced by the Bartlett board when they stated for the Juneau Empire, “… in the health care industry, severance is commonly paid to higher-ups regardless of how the person leaves the job.”
Last year, I needed surgery that would require an overnight stay in the hospital following the procedure. I contacted Bartlett Regional Hospital in an attempt to determine the estimated costs, providing them with all diagnostic codes. They were beyond unhelpful and I was not able to obtain an estimate. I contacted a Seattle-based hospital, obtained an estimate and decided to have the surgery there. I had the financial resources to make this choice. For many citizens of Juneau, this choice is not an option.
Given the continued problems at Bartlett Regional Hospital and the lack of cost constraints, I believe that it is time to consider replacement of the hospital board and the current Assembly liaison. We need and should demand greater transparency in the fee structure of our city owned hospital and greater accountability from the Board of Directors. It appears that the current administrative structure is a closed system designed first and foremost to benefit hospital management.
Many of my friends and co-workers have discussed the Sunday Juneau Empire article and voiced disbelief. Some believe that the CBJ Assembly should take greater charge of the hospital management and some believe that the citizens of Juneau need to take greater responsibility.
Personally, I will seek health care at facilities that respect my limited income and those that will provide cost effective health care. If that means traveling outside of Juneau — so be it.