In his book “Mistreated,” Robert Pearl, M.D. talks about the four “legacy players,” that resist needed change in our dysfunctional, expensive healthcare system—because they benefit financially from the status quo. These entities are hospitals, medical insurance companies, physician specialty societies, and the pharmaceutical/medical device industry.
Last year, Elisabeth Rosenthal, M.D., wrote the book “An American Sickness, How Healthcare Became Big Business and How You Can Take It Back.” She writes about how in the last 25 years “healthcare, the caring endeavor, became healthcare, the highly profitable industry,” and about how “our politicians have proven themselves either unwilling or unable to rein in the increasingly outrageous costs faced by patients.”
In regard to hospitals, Dr. Rosenthal notes that “from 1997 to 2012, the cost of hospital services grew 149 percent, while the cost of physician services grew 55 percent. The average hospital cost per day in the United States was $4,300 in 2013, more than three times the cost in Australia and about ten times the cost in Spain.” Following are a few of Dr. Rosenthal’s thoughts on how hospitals contribute to the high cost of medical care in this country:
Based on advice from consultants, hospitals– including nonprofits– boost charges as much as they can on whatever they can, including operating room time, oxygen therapy and drugs (note that usually hospitals won’t let you take your own medications during your admission). We all have experienced—or known others who have—outrageous hospital charges, such as $48 for putting an oximeter on a patient’s finger for a few seconds to check pulse rate and oxygen saturation (the device costs less than $50 at Walmart, is reusable, and lasts for years)–or $17 for an acetaminophen tablet which costs well under a penny.
In a section of the chapter on hospitals titled “closing departments: make money or die,” Dr. Rosen notes that “hospitals…enhanced their most profitable offerings: orthopedics, cardiac care, a stroke center (revenue from expensive scans), and cancer care (revenue from infusions)” while closing departments that aren’t very profitable, even if they benefit patients.
In talking about “the emergence of hospital-hotels,” Dr. Rosenthal notes that 25 years ago rooms with four beds were common, but now single rooms are the norm, even though “there is little medical justification and many insurers won’t cover them.” A health economist quoted by Dr. Rosenthal says hospitals are “like Four Seasons Hotels, with valet parking and chandeliers.” (The book doesn’t mention fireplaces in the rooms, probably because readers wouldn’t believe that such a hospital exists).
Many hospital CEOs are paid exorbitant salaries, even if the hospitals they manage are nonprofit. “An American Sickness” notes that “in most cities the highest-paid nonprofit executive by far runs the local hospital.”
Putting an E.R. patient on observation status while getting tests to determine the diagnosis and need for admission made sense in the past, before modern diagnostics such as CT scanning became available. Many hospitals now abuse the system: Rosenthal explains that “the easy money for Medicare patients is not in inpatient admissions. Medicare pays a bundled rate for those. But outpatient care has no similar limits–the till is open for testing.”
Many hospitals, especially community hospitals, are nonprofit, which allows them to receive huge tax benefits. They hire consultants and accountants to figure out how they can maintain their nonprofit status while doing the minimal amount of required charity and community benefit work.
At the end of her book Dr. Rosenthal has a section that lists the following sites you can use to vet hospitals in your area:
Propublica Nonprofit Explorer (https;//propublica.org/nonprofits) and Guidestar (guidestar.org) “allow you to download an IRS Form 990 for most hospitals.” For a nonprofit such as Valley View Hospital, these sites include the compensation of the hospital’s highest-paid executives and doctors, what they claim as charitable work, and what the profit was every year.
Yesterday Switch 4 Good, a non-profit with the mission to bring attention to the athletes who gained competitive advantage and a healthier, more vibrant life, with a whole-foods, plant-based lifestyle, premiered an add at the Winter Olympics closing ceremony. http://switch4good.org/ Read the article in Adweek
Food stepped back into fashion with farmers markets and smart chefs. Beguiled by scrumptious stalks and orange spice, we were seduced not scared. But now we fear fatty cows. Food isn’t just a hot date anymore and we’re wondering where to turn.
Well, food as medicine is forging new alliances these days—savvy, healthy alliances—from medical schools and culinary institutes to local restaurants and global symposiums. Help is on its way.
This week, news of massive egg shortages in the fallout of avian flu has corporate food giants knocking down that company’s doors. As much as one third of U.S. egg production is broken down for use in thousands of products from hotdog buns to pancake mix.
Bill Gates knows a hot trend when he sees one, but no one could have predicted this massive flu, which is being tagged the biggest livestock crisis in U.S. history. More reasons—and more urgent reasons—for all of us to consider the benefits, short term and long, of a whole foods plant based diet.
The egg has been a controversial orb for decades. Should we eat them daily, eliminate the yolk, or never poach one again? Recent debate over the newest round of U.S. Dietary Guidelines has people rehashing breakfast again.
A small group of plant-based inventors on the West coast are sidestepping the issue entirely—but not without homage to a classic American meal. Dubbed Just Scramble, the product is a plant protein prototype created by three chefs under the umbrella of Hampton Creek, a small tech company who produced Just Mayo, an eggless alternative to Hellman’s and other popular brands.
The Paleo lifestyle is hardly trending anymore. Between January and March of 2012, two medical panels and a number of articles have pointed out shortcomings in Paleo’s nutritional values and cast doubt on a society’s ability to replicate primitive diets in a contemporary world.
Dr. David Jenkins is a Canada Research Chair in nutrition, metabolism and vascular biology, a professor in the department of nutritional sciences at the University of Toronto, and scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. In addition, he is the first Canadian recipient of the Bloomberg Manulife Prize for the Promotion of Active Health.
Dr. Jenkins is a frequent subject of worldwide news, particularly in Canada, but recent reports have more to do with his change of mind than his list of accolades. Dr. Jenkins, who also happens to be the lead architect of the glycemic index, announced recently that his personal lifestyle of choice is plant-based. Though his research inspired some of the most famous diets in the U.S.—Atkins, The Zone and South Beach to name a few—he is now stepping into the arena himself, by proposing a global revolution in the way we eat.