Why Is Health Care So Expensive?

High Cost DocumentationDuring the last couple of weeks, I got a first hand reminder of what  it is like in a health care system.  My late Auntie Marie was hospitalized for a few days before she died. Of course, Peggy and I visited often during those days. There was one thing that stuck out as I walked the halls of a well known suburban hospital. No matter which floor we were on,  or which nurse’s station we were near, people were diligently entering data or writing on charts.
I began to wonder what that was all about. Very few of these people were tending to patients, yet all of them were very busy. These people are all very expensive. Health care workers don’t come cheap. What is so important to require so much documentation? I quizzed my daughter, who is a nurse, to explain. We had a very nice father daughter discussion on the matter. She cleared up some of my mis-conceptions.
In summary here is why they document:
1. If it ain’t documented the insurance company, Medicare, etc. doesn’t pay. Of course the hospital is a business, and requires money to run. Patients never like to pay for their own health care,  therefore they pay for insurance to pay the bill for them. The insurance companies are also in business to make a profit. They sell us policies with fine print defining just what they will cover. Medicare does the same thing. Their rules are just as stringent as any insurance company’s. Therefore, hospitals document in order to charge.
Insurance companies take a bad rap when they cite the fine print in a policy, and refuse to pay. We should all be more careful when we buy policies. We tend to go for the lowest cost. Of course we do, why pay more? Except we don’t read the details, or the details don’t matter when we sign the contract. There is a famous insurance company commercial, running now, that touts the ability to tailor make a policy to fit your budget. Guess what? They do it by limiting your benefits. We go for price, they go for the sell, and we are happy until we get into a health crisis and the bill comes to us. 
2. Doctors need information from the nurses in order to make your health care decisions. They work by reading test reports, and the charts documenting vital signs such as temperature, blood pressure, heart rate, and  repsonses to medications.  Doctors also write instructions to the nurses for your treatment. Then, as a CYA they document their treatment plan and diagnosis. Again, if it ain’t documented they don’t get paid. A doctor  might spend ten minutes per patient reading a chart, and two minutes talking to him. If you have a serious problem, the doc may take three minutes to explain the prognosis.  Nurses document your vital signs, and dispense drugs. Certified Nursing Assistants do all the other dirty work of keeping patients comfortable. In the good old days, the nurse did it all. My wife Barbara tended to a surgical ward at West Side VA hospital back in 1959. She took care of, and documented up to thirty patients at a time. Life was simpler back then.
3. Hospitals have quality control programs. They are crappy compared to the ones  industry has  put into place to make all the products, and drugs they use, but they have systems.  These systems require documentation. In my business, we said that if we could measure something, we could improve it. Therefore, any quality system requires data documenting metrics that can show management if they are doing well. Most hospitals require you to complete a satisfaction questionnaire when you leave. This is an example of their input.
4. Lastly, health professionals document to CYA (cover your ass). All doctors and hospitals are so afraid a patient will sue them that they over document in order to cover themselves in the event that one of them makes an error. Or, if the patient and his family perceive a screw up.
The bottom line is that I saw dollars with wings and heard a cash register ringing as I walked the corridors of that hospital.
Obama’s solution to this problem is to invent a totally new health care system to compete with the one in place. If the actual health care industry doesn’t know how to fix their problem, what makes us think a group of Congressman and Senators can  invent  a new system to fix it all?
Bend over America, the government wants to give you an enema.
In a future post, I will present a plan for realistic reform. Stay tuned.
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