Pop Quiz:
A) Note the trend.
B) Spot the problem.
Ancillary data: Private business (and even public facilities at county and state level, to a lesser extent) generally only needs or adds additional administration positions to comply with burdensome government regulations, as otherwise, they add nothing to the business model except excess costs.
See if you can therefore guess a way to cut healthcare costs by decreasing the number of administrators necessary to do business.
Answers up to and including the use of tactical "special" weapons on certain agencies in Washington D.C. are fair game for discussion.
Begin.
Bonus point: look at the graph timeline on the "x" axis. See if you can deduce what changed in America in the early 1990s that might have necessitated an increase in administrators.
Hint:
Elections. Consequences. Self-assembling.
Washington D.C. Is the home of some of the best museums, buildings, and history of our country. I would like to preserve that. My suggestion is a neutron bomb detonated just high enough to kill all the swamp creatures but spare the surrounding communities. Then, rebuild a new national center for government in about the geographical center of the country, like around Fort Leavenworth. New, functional, efficient buildings with a good prison nearby for use, or as a deterrent.
ReplyDeleteHey, I said "certain agencies", not the entire District.
ReplyDeleteThe graph for education would look exactly the same.
ReplyDeleteWhen you get charged seven dollars for a can of 7Up at a hospital that should be a clue that something is fucked up.
I had that happen to me clear back in 1995 in a San Francisco hospital.
There are billions of dollars flowing through these systems, they have to justify their existence somehow.
This is a symptom of having a service economy. If we still had a manufacturing economy many of these people would be Blue Collar workers instead of White Collar.
My Sister In Law makes more money, sitting on her ass inputting data for medical insurance companies than I do with forty fucking years experience in heavy equipment, vehicle and industrial plant repair and maintenance, breaking my balls every damn day.
The bigger lesson is that you're paying for sizzle, not steak.
ReplyDeleteYou're not getting better nursing care at 7 times the cost, or more doctor supervision, or better monitoring, or stronger medicines.
You're getting a parking structure for 3000 administrative weenies, and pastel hallways, and reams of paper that don't do anything to improve your care a whit; in fact, usually the opposite, because the care-giving side, from cleaning the rooms to actually taking care of you, are usually underpaid and short-staffed. And the mountains of clipboard commandos can't figure out how A leads to B.
I imagine that caring for an increasing number of sad sack drug users, illegals and indigents would account for some of that cost increase too. That $7 can of 7Up is also used to pay for Aesop's salary.
ReplyDeleteNot so much. Look at the graph.
ReplyDeleteEMTALA sucks, but it's a pittance compared to the regulatory burden, and the staff to service it.
Alinsky's plan in action.
ReplyDeleteas an exemplar, recall briefly the dizzying clusterfuck of Suits In Motion! generated by the looming inspection by JCAHO, or whatever heir alias is these days. More clipboards, more administration venturing out, Punxatawney Phil-like, to sniff and try to see the shadow, before the JCAHO inspectors slither away with the light.
ReplyDeleteYeah. Those were good times. Fun Fact! Suits are not force multipliers!
Wife works in healthcare and I worked in a non healthcare capacity in three hospitals. Of the administration people I've met damn few serve any real purpose. The supervisory people above the doctors and actual medical staff were far too often just breathtakingly incompetent. The level above them existed to waste staff and supervisor time with pointless dumb ass repetitive meetings, HR PowerPoint presentations and all manner of time wasting bullshit which didn't help treat patients, operate more efficiently or make freaking money. If Bob's plumbing, A-1 general contracting, Earnie's Gas and Lube or a farm or fishing boat were run like the medical industry it'd be bankrupt and on its ass in a month.
ReplyDeleteThe whole billing and insurance system is a boiling cauldron of clusterfuck that has to be experienced to be believed. I seriously cannot deal with it anymore. When billing and insurance gets involved I hand it off to the wife because I can't guarantee I'll be able to deal with those people in a civil manner.
I'm not alone in the frustration. It's everywhere. People are tired of dealing with skyrocketing insurance and medical costs, spending hours on the phone dealing with billing departments and insurance companies and having reams of indecipherable statements and bills coming in the mail from both sides. Eventually people are going to say to hell with it and demand a single payer government run healthcare system. It'll be a disaster and a fiscal calamity but people are so sick of the status quo they'll be willing to try anything. They'll say yeah it'll be expensive, yeah it's socialism and the care will suffer but it can't be worse that what we have now. I know they're wrong, you know they're wrong but it won't matter. They're sick of it and they're pissed and if someone offers a "solution" they're gonna grab it. Maybe that's the point of all this dysfunction to begin with.
You must understand, the healthcare, insurance and billing system in the US is working perfectly. Perfectly as designed...
DeleteThe graph says that administrators are managing your healthcare more than physicians (or PAs or nurses or techs) are.
ReplyDeleteExistence doesn't necessitate responsibility.
ReplyDeleteCows outnumber the dairy farmer, but they don't direct the enterprise.