After class the other evening, I was wondering about the specialty hospitals we spoke of briefly and had some questions about their existence. From what I have read, the only types of specialized hospitals that exist are ones that specialize in cardiac, orthopedic, and general surgery. There are very few of these hospitals and are typically geographically located in a small area (Kansas, Oklahoma, South Dakota, and Texas). The major issue surrounding these hospitals is the fact that many claim they are taking away the most profitable and generally easier cases from community hospitals. This argument relies on the fact that patients at these hospitals are generally insured on other policies than Medicare and are not in highly emergent situations. While I definitely understand that community hospitals rely on insured patients for much of their funding to cover uninsured patients and patients with Medicare that does not pay as much, specialized hospitals really do not seem to have anything to do with this problem other than they are taking some of the insured patients away. Therefore, it seems that the overall complaint with specialty hospitals is not going to be addressed by not allowing them, but by correcting the payment problems at community hospitals.
I think that patients should have a choice in where they receive their care and not be forced to make up for losses that are incurred elsewhere. As I was reading this article, I could not help but think of nationalized healthcare. A nationalized healthcare system would correct the problem of uninsured patients and also presumably help Medicare type insurance pay more money. However, a nationalized healthcare system is bound to have a privatized option that will take the same form as a specialty hospital.
A further issue that is raised in the article is the one of conflict of interest of a doctor’s who own hospitals. However, with this point, the article cites statistics that state the doctors individually only own very small parts of these hospitals, 1% per physician. Also, with cardiac specialty hospitals, physicians only own 34% of the hospital on average. These seem like small numbers to be creating conflicts of interest. A further point is that it seems like a far stretch to be saying that physicians are performing surgeries that they otherwise would not be because they own a small part of the hospital. This argument would make much more sense in a different field like dermatology (which by the way is a specialized practice usually that is owned by physicians). To me, it makes more sense that a dermatologist might prescribe is different medication that they profit more off of rather than a different option that is cheaper well before a cardiac surgeon performs a procedure on someone’s heart that is unnecessary. While the cardiac surgeon might also prescribe a different medication, that is a different point and will exists no matter where the physician is working.
In the end, I definitely do not know much about specialty hospitals, but these were just a few thoughts I had. The last thing that I thought was interesting was a website for a specialty hospital that claims:"Some day all hospitals wil be like this."
1 comment:
It is interesting to me that more emphasis is not placed on where the specialty hospitals in existence are located. If specialty hospitals are predominantly in states like Kansas and Oklahoma, where population is more rural, my intuition is telling me that the location might be perhaps the most significant part of the problem. Where population is less dense, taking (the more valuable) patients away from general hospitals is definitely going to have an effect since the amount of people needing treatment is limited. However, consider if a specialty hospital existed in a major city, perhaps Chicago. Sure, some patients would be taken away, but wouldn't there still be MANY more who either couldn't get in at a smaller specialty hospital or simply still were treated at a general hospital?
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