(Editor’s note: The following is the first in a three-part series on the state of healthcare in America from the inside looking out. In this first part, Liberty Nation discusses the anomaly that is the current healthcare system.)
Now that Republicans have laid their cards on the table regarding the repeal and replacement of Obamacare - a foundational promise of Donald Trump and the GOP in the election campaign - politicians of both parties will be making the rounds defending or denouncing the new program entitled the “American Health Care Act.”
The problem is that the political class is speaking to us from 30,000 feet. They are focused primarily on the macro-level, on the shape of this new federal legislation, but we the consumers experience healthcare at the micro-level. We know little or nothing about the arcane language embedded in either the 2200-page Obamacare bill or the new one hundred ten-page replacement, but we sure do know about how well we are treated by our doctors and hospitals. We know about the spiraling costs and rising deductibles. And we come face to face with those who know best about the state of health care - the people who run the operations on the ground.
Those who have implemented and administered health care in hospitals and medical facilities have their own ideas about how to fix the multiple and growing problems in the system. Liberty Nation sat down with Alan B.Kelly, Esq., who for a dozen years functioned at the highest levels of legal, risk management and corporate operations at HonorHealth, the largest healthcare concern in Arizona, and was formerly Chief University Counsel at Thomas Jefferson University in Philadelphia.
LN: Could you tell us what you think needs to happen to the hospital industry with this new administration?
Mr. Kelly: You know, hospitals and the way they reimburse and the way they operate are a tremendous anomaly. There's nothing like them. They are paid differently. They are not transparent. You have no concept of what you're getting. If the hospital or the provider, whoever it is, does a lousy job, they get paid the same amount. Now, where else in the marketplace does that really happen. You would not accept, for example, waiting in a place to be serviced for four or five hours, and yet be expected to pay for those four or five hours. That's exactly what happens in health care. I just want to add one thing. There's so much waste. The loneliest place that you ever want to be is a radiology department on a Friday afternoon in a hospital. Do you know why that is?
LN: Why?
Mr. Kelly: Because there's no one there. They're all gone. If you are admitted on a Friday, the chances of you being seen by or any images or any tests really being seen, except emergency tests that come out of the emergency room, are very slight. They have no incentive to really stay there. You have 39, 40, 50 CT scans in a small city. They're not running all the time. They're not utilized to their capacity. The people who are paying for it is the American public.
LN: How so?
Mr. Kelly: Well, let me ask you a question. How many airports, in fact, does a metropolitan area like, say Philadelphia have?
LN: One.
Mr. Kelly: One, and that airport is used 24/7, isn't it?
LN: Right.
Mr. Kelly: How many hospitals do you think are in the metropolitan area of Philadelphia?
Over 50. Each of them has innumerable numbers of MRI's which cost well over a million dollars. CT scans which are now close to a million dollars. You have 3D imaging machines, maybe six or seven of them in hospitals. You have infusion pumps that are not used. These things are all purchased by hospitals who don't have to pay taxes, and they are under-utilized. You have so much capacity that you're not utilizing the materials that you have, and the public is actually paying for it.
LN: But doesn't that give the consumer more choice?
Mr. Kelly: Well, you'd think that would be the case, but again, the hospital industry is an anomaly. The only thing that the consumer has been able to shop for in a procedure in at least the last thirty-eight years of my long career in healthcare is, ironically, cosmetic surgery. You cannot go online and find out what a hip replacement will cost, what a heart procedure will cost, what an elbow or shoulder replacement will cost. There's no transparency. ~
The new federal legislation now being debated by House committees addresses many of the large issues that have arisen in the healthcare industry, but it does not - it cannot - address the fundamental issue of transparency. That is why the common-sense observations and recommendations of Mr. Kelly and others who have dealt with the issue on the ground every day must be heavily considered at the local and state levels. It was the total lack of such input that helped to sink Obamacare.
In Part two of this series tomorrow, we will drill down with Mr. Kelly on the matter of transparency within the industry, as well as another issue at the heart of the debate - the quality of care.
