The Spectacle Blog

Our Bureaucratic Health Care System

By on 8.2.06 | 4:29PM

Our health care system is plagued by bureaucracy, both in the government and the private sector. Having for years been accustomed to the third-party payer system, much the private sector has created structures designed to hold down costs and wring more dollars out of the federal and state governments.

Hospitals are one example of this. As we turn to a more consumer-oriented system with the adoption of health savings accounts, hospitals are struggling to adapt. Holman Jenkins has a great article on this in today's WSJ (subscription required). Here are a few snippets:

[Hospitals] don't publish price lists. They don't advertise promotions and discounts when facilities are idle. Though hospital CEOs are still prone to believe it's government's job to bail them out, plenty of lessons from other industries are available as they adapt to the end of third-party payer socialism. Movie theaters, grocery stores and car dealers all make sure you pay for their goods and services whether they charge you before or after the fact. Yet hospitals are just discovering such ploys as getting the customer's credit-card data before he lies down on the gurney. One hospital, looking at procedures that exacerbated its bad debt problem, found that nobody was stopping emergency room patients from walking out the back door without passing the cashier.


Hospitals like to blame a mild flu season for an unlikely softening in admissions the last year or so, but they're whistling past the operating room. The Los Angeles Times noted on Sunday that insurers and employers are just starting to look at sending surgery patients to India or Thailand, where a state-of-the-art procedure can cost 10% of the U.S. price.

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