Is your hospital hurting you?
http://www.cnn.com/2013/01/02/opinion/makary-hospital-doctors/index.html?hpt=hp_bn7
The author is quite amusing to me. He somehow thinks that the massive consolidation of hospitals has anything but financial gain for the already wealthy behind it. Oh, I am sure that there are a handful of cases where a local group of hospitals got together administratively in order to provide better service, but I am also quite sure that that case (maybe there are more? I doubt it) is the exception held up by the corporations doing consolidation as justification for their money grab. Yes, in principle, it is possible to get economies of scale and wind up with better medicine at a lower cost, yet that never seems to happen. However, if it was just plain old incompetence that lead to some hospitals being run less efficiently combined then separate, by plain old statistics/happenstance/randomness you would expect there to be about half the hospitals to be better off after merging.
I have no doubt that Dr. Makary is a smart guy (few dummies become surgeons anywhere, let alone Johns Hopkins), but he is looking at the world through rose colored glasses and will never have any measurable impact as long as he wears them. Hospitals clearly should not be operating at a deficit, but by the same token, they should not be operated to produce million dollar salaries for executives (or doctors!). As long as the profit-at-all-costs mentality is the driving force behind medicine (and with the plethora of billion dollar pharmaceutical companies we have, that is no doubt the case today) we will never reverse our increasing health care costs until we all go bankrupt. Then, like in all other cases, the oligarchy that got further bloated by feeding on our corpses will just shift off to some other part of the world to continue feeding.
