- Disposable everything (good for sanitary care, but super bad for the environment)
- Not being able to use the patient's own medications when they are admitted. Instead, patients must use the hospital dispensed medications, and hugely inflated prices. ($6 for a Tylenol anyone?)
- Overpaid executives (we just got a new one this month in addition to the rest of the overpaid execs!)
- Free food for physicians (doctor's lounge -- free food all day long). Seriously? Of all of the people employed in a hospital, these people can afford to cough up the dough to buy their own food. Or (gulp!) bring it in from home!
- Multiple items in packs of instruments/delivery packs/c-section packs/epidural packs. Not everything is used when a pack is opened. The rest that's unused? Thrown in the trash. Very wasteful.
- Full bags of IV solution disposed of in the red bag (biohazard) trash. That stuff is charged by the weight. Hello? IV fluid left in the bag before you toss it? Pour it down the sink. Little things like this add up.
- People who don't pay their medical bills/co-pays etc. Then it goes to collection (costing more money to the hospital/health provider). Prices get jacked up due to non-payment of accounts, to cover this loss. Thus, in turn, the insured are billed higher and higher amounts for the same services. Not like the insurance companies are willing to pay full price for services, but anyway...
- Coming in to the hospital for things that do not need hospital evaluation. Hi! A regular outpatient charge on Labor and Delivery --- just to walk in the door and be evaluated --- is $900+. Add on other charges (NST = another several hundred bucks). Multiply this by several visits per pregnancy. Oh wait, the "insurance" pays for it. Think again. It's all pro-rated. The hospital eats up the leftovers. After they pay the nurses for hours worked to provide your non-essential/not hospital needed care. And Medicaid? It pays pennies on the dollar for services billed. More than likely, the hospital pays out more to employ the nurse, and doesn't recoup enough of the nursing per hour cost to break even.
Any other fine examples of waste and irresponsible spending?
12 comments:
Very disturbing. What are your thoughts on practically reducing these costs so that safety is not compromised and good health care practices remain?
AYC:
I worked at a facility that actually encouraged us to empty anything that was not hazardous (liquidwise) before disposing of it, due to weight costs. It does make a huge difference.
And if it's not biohazard, don't put it in a biohazard bag. This controls costs, too.
It would be nice if people would educate nurses on what each item in the supply room costs, so people could be more careful with things (like not taking a whole box of silver dressings into a patient's room).
It is money well-spent to have every person be the quality inspector, instead of just waiting for one to come in on inspections.
I know things are "going paperless" but I see so much paperwork still. I filled out so many papers of questions at the OB office, at the new OB office (my midwife moved) and then at office where we got our sonogram, and then at preadmit, and again while in labor and delivery. It's too bad some of that information couldn't be passed on without rewriting it. Moms coming in early for labor...that seems like a waste of staff and such. Also, hospitals that switch rooms for triage/labor and delivery/and then postpartum. I used three rooms to have my baby. Three. And then, assessments done in the nursery! So really, we used 4 rooms for one little baby. If we could have the baby in the same room we stay in, that would be lovely. And then nurses could do all assessments in the same room. Wouldn't that save money? So many rooms to clean! EEK! My hospital has remodeled too since I had my first in 1996. They remodeled the NICU, and have redone the whole L&D floor. It's really about the same, just new decor and maybe a few added rooms since they made postpartum rooms much smaller. But, in the long run, they did all that construction and still have moms switch rooms after birth.
I'm an L&D RN and we always thought that having people pay a hospital co-pay would make them think twice about coming in. Even if we just charged $5 a visit, maybe those patients with trich (or any other non-emergent problem) could wait to be seen in the clinic.
And Anonymous, I see what you mean about the cleaning, but you have to understand from an RN standpoint, patients who come in saying they're in labor are rarely in actual labor--and it's so much easier to clean a triage room than a labor room! Also, I recommend looking into a hospital with an LDRP unit for your next delivery. In an LDRP, you Labor, Deliver, Recover, and have your Postpartum time all in the same room. L&D requires a different skill set than Postpartum and that's generally why units are separate and you move rooms after your delivery. An LDRP RN has to be an expert in all the areas of mother/baby, and that's generally a lot to ask, especially at a high-risk hospital.
OK, wow! Off my soapbox now...
Hey Hey Hey lighten up on the free doc food. We lard asses need to eat too!
Seriously, we could talk forever on the costs of health care. As a matter of fact we should.
I give one anecdote. There is an ER doc here that is a failed non board certified FP and terrified of a law suit. He orders a CT on virtually ever patient before they are seen. This is the fourth largest hospital in the state and he does enough CT's that they finally put a new scanner with complete team in the ER for him. How many you ask? Just over 4,200 last year. He CT'd my patients head and abdomen for a spinal headache last week before calling me.
Birth centers and free standing surgi-centers have a much better grasp on cost containment and they are purely consumer driven.
How about a 1/4 million "stabilization room" that construction started on before it was decided "how" or even "if" it would be used. It wasn't. But it makes a great storage room!
This is one reason that I was so irritated that the FAMIS/Medicaid insurance that I qualified for did not cover my licensed midwife. I declined most tests other than the 20 week ultrasound and have never had any complications, yet they would rather pay the OB fee and the hospital costs than one low fee for the midwife, who runs an accredited birth center? So I will be paying for the birth (5 weeks ago) for the next year, because I really couldn't afford it!
How about Makena??
Hi AYC!
I think you nailed this one on the head. My only worry is if someone reads this and cuts out my free physician lounge food--on busy ER days I will be forced to eat saltines for nutrition! ugh! :)
Hope you are well...
Jim
People in the government talk about reducing the cost of health care, but really, I think they make it more expensive.
For a while my entire job consisted of stuff the federal government required/wanted and for the most part, was completely useless to our consumers, patients and providers alike.
Multiple items in packs of instruments/delivery packs/c-section packs/epidural packs. Not everything is used when a pack is opened. The rest that's unused? Thrown in the trash. Very wasteful.
Regarding this - I have heard of a few hospitals where nursing staff noticed that certain items in their packs were never getting used and successfully negotiated with their supplier to change what was in the packs to omit the items that were hardly ever used (they were cheaper and there was less waste - win-win!). I have also seen programs where hospitals collect these unused items and send them to Africa or Haiti where hospitals are desperately in need of basic supplies. Any chance that these could become more widespread solutions that would save money and/or resources?
It is so expensive because of the medicines and materials to cure illness.
David Fellers @ AABSN Program
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