health care

Free Markets Would Improve Hospital Service

Instead, hospitals are run like socialist bureaucracies.

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I write this from the hospital. Seems I have lung cancer.

My doctors tell me my growth was caught early and I'll be fine. Soon I will barely notice that a fifth of my lung is gone. I believe them. After all, I'm at New York-Presbyterian Hospital. U.S. News & World Report ranked it number one in New York. I get excellent medical care here.

But as a consumer reporter, I have to say, the hospital's customer service stinks. Doctors keep me waiting for hours, and no one bothers to call or email to say, "I'm running late." Few doctors give out their email address. Patients can't communicate using modern technology.

I get X-rays, EKG tests, echocardiograms, blood tests. Are all needed? I doubt it. But no one discusses that with me or mentions the cost. Why would they? The patient rarely pays directly. Government or insurance companies pay.

I fill out long medical history forms by hand and, in the next office, do it again. Same wording: name, address, insurance, etc.

I shouldn't be surprised that hospitals are lousy at customer service. The Detroit Medical Center once bragged that it was one of America's first hospitals to track medication with barcodes. Good! But wait—ordinary supermarkets did that decades before.

Customer service is sclerotic because hospitals are largely socialist bureaucracies. Instead of answering to consumers, which forces businesses to be nimble, hospitals report to government, lawyers and insurance companies.

Whenever there's a mistake, politicians impose new rules: the Health Insurance Portability and Accountability Act paperwork, patient rights regulations, new layers of bureaucracy…

Nurses must follow state regulations that stipulate things like, "Notwithstanding subparagraph (i) of paragraph (a) of this subdivision, a nurse practitioner, certified under section sixty-nine hundred ten of this article and practicing for more than three thousand six hundred hours may comply with this paragraph in lieu of complying with the requirements of paragraph (a)…"

Try running a business with rules like that.

Adding to that is a fear of lawsuits. Nervous hospital lawyers pretend mistakes can be prevented with paper and procedure. Stressed hospital workers ignore common sense and follow rigid rules.

In the intensive care unit, night after night, machines beep, but often no one responds. Nurses say things like "old machines," "bad batteries," "we know it's not an emergency." Bureaucrats don't care if you sleep. No one sues because he can't sleep.

Some of my nurses were great—concerned about my comfort and stress—but other hospital workers were indifferent. When the customer doesn't pay, customer service rarely matters.

The hospital does have "patient representatives" who tell me about "patient rights." But it feels unnatural, like grafting wings onto a pig.

I'm as happy as the next guy to have government or my insurance company pay, but the result is that there's practically no free market. Markets work when buyer and seller deal directly with each other. That doesn't happen in hospitals.

You may ask, "How could it? Patients don't know which treatments are needed or which seller is best. Medicine is too complex for consumers to negotiate."

But cars, computers and airplane flights are complex, too, and the market still incentivizes sellers to discount and compete on service. It happens in medicine, too, when you get plastic surgery or Lasik surgery. Those doctors give patients their personal email addresses and cellphone numbers. They compete to please patients.

What's different about those specialties? The patient pays the bill.

Leftists say the solution to such problems is government health care. But did they not notice what happened at Veterans Affairs? Bureaucrats let veterans die, waiting for care. When the scandal was exposed, they didn't stop. USA Today reports that the abuse continues. Sometimes the VA's suicide hotline goes to voicemail.

Patients will have a better experience only when more of us spend our own money for care. That's what makes markets work.

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  1. Oh, fuck, that is a bummer! John, I wish you all the best and hope they cut out all of it and it never comes back. Please get well soon! We need you. My thoughts are with you.

    1. Also, please don’t start cooking meth.

    2. Hey, John.

      Get your genome done to check for compatibility of your drug metabolism with the drugs they want to use on you for treatment and surgery.

      And trust no one. Know and check everything you can, or have a family member do it. Hospitals are just as bureaucratic and incompetent as any other bureaucracy.

      Good luck.

      1. ^This times a thousand! It’s a relatively simple test that can head off so many complications but often times isn’t checked and patients don’t know to ask for it.

    3. “A fifth of my lung is gone” indicates lobectomy, which probably means the tumor wasn’t close to the edge of a lobe, which means it’ll probably be gone.

    4. This 100%. Hope you get better soon.

      And to keep you busy while you’re laid up, this would be a good opportunity for you to do some investigative reporting on what would work in healthcare. Obviously more socializing wouldn’t. The current system sucks too. But I’m not sure how a true free market works either – since you are now facing the reality of a market with information asymmetry (doctors may or may not even know what works – but they don’t have any incentive to do less than everything and charge for it) and inelastic pricing (how much can be charged for the one thing that does work – and is there an ethical issue if the patient can’t afford that?).

      I look forward to reading what you come up with. Which means I look forward to you getting better too 🙂

  2. This is terribly saddening news, John. I wish you a speedy recovery and all the best. We need you!

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  4. Mother Nature is a bitch. A friend got lung cancer at 74 having never smoked in her life. The world’s longest living person at 122 smoked until she was 117.

    Hope to see you well and back in front of the cameras soon.

    1. See that? Quitting smoking killed her in 5 years!

      As fewer people smoke, of course the proportion of smokers among lung cancer patients also diminishes, because not all lung cancers are smoking-related. My father died of an adenocarcinoma of the lung more than 50 yrs. after he quit smoking, but he was in his 90s when he died. The large cell tumors like adenocarcinoma are less likely to be related to exposure to smoke or other known carcinogens that are commonly inhaled.

  5. It’s not a socialist bureaucracy, John. That’s not real socialism. It’s social democratic ism. /ex-democratic socialist

  6. Leftists say the solution to such problems is government health care. But did they not notice what happened at Veterans Affairs?

    Leftists *rationalize* that the solution to all problems is more government power. Don’t be fooled into thinking that they believe it.

    It’s not that Leftists didn’t notice what happened at Veterans Affairs, it’s that dead veterans are irrelevant to their goal of more government power.

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  9. Get well soon, man. Eat an edible to help with the symptoms. Oh and don’t worry about the stash and the treatments I’m sure it will grow back bigger and stronger which can only help in the fight against our bloated government.

    1. Fuck edibles. Vape. Better dosage control, faster effect.

  10. My brother had a double lung transplant at Presbyterian. They are wonderful. .. I wish you all the best.

  11. Hey John,
    Eeks! I’m glad they caught it early and I hope you aren’t in any pain. Hopefully you’ll get to indulge in some good edible tree though 😉 Best wishes on your recovery! A lot of folks definitely want and need you around for a lot longer, so take it easy and get better soon! 🙂

    In the meantime, here, have a cat: https://cdn.meme.am/instances/500x/67966895.jpg

    1. Cat? Sneezing’s the last thing you need when you’ve just had lung surgery!

      Unfortunately the surgery is likely to cause him pain. Here’s hoping he doesn’t have to be on narcotics the rest of his life like Dave Lindelof after his lung CA removal.

  12. But as a consumer reporter, I have to say, the hospital’s customer service stinks. Doctors keep me waiting for hours, and no one bothers to call or email to say, “I’m running late.” Few doctors give out their email address. Patients can’t communicate using modern technology.

    Welcome to the side-effects of smaller government and the cutting back of government expenditure in hospitals. Staff numbers are curtailed and customer service technology is kept in the 20th century because they can’t afford the more expensive modern sort,

    1. So, you’re saying more government will make everything better? How did you even get in here?

      1. So, you’re saying more government will make everything better?

        No, I’m saying that cutting back the funding of public hospitals produces fewer doctors, nurses, and other staff, and therefore longer queues. This is Economics 101, and would apply just as much to a private hospital run by corporation as to a public hospital run by a government.

        2-1 does NOT equal 3.

        And BTW, just what do you mean by “more government” anyway? Are you insinuating that more doctors and nurses equates to more government and ergo is bad?

        1. He was reminding you that the healthcare system is fucked up and stupidly expensive because of all the government intervention already in-place. A hospital, like any other business, does not better serve its customers or deliver a better, cheaper product because it has to support a byzantine bureaucracy in order to navigate the dictates of the state; quite the opposite is true.

        2. Most physicians, that I knew, were leaving medicine because their income was being limited, by decreasing reimbursements from insurance companies. That has worsened with the ACA! I don’t miss swimming with the sharks! But, I was eliminated from the employment pool by the competition!

    2. It’s really fucking hilarious that some people think that American healthcare is “unregulated” or that there is a “small government” approach in that area.

      Go take some classes in health information management, then come back and tell me that healthcare is some kind of Wild West, free-wheeling capitalist paradise.

      1. Did you actually read my post?

        Where was the word “unregulated” mentioned in it? And where was I advocating “small government”?

  13. Stay strong, John. You will beat this.

  14. “I fill out long medical history forms by hand and, in the next office, do it again. Same wording: name, address, insurance, etc”.

    Just one of many areas in which innovative technology could vastly improve operations. In my project management class, my team just finished a project for implementing a tablet-based electronic medical record (EMR) system for addressing this exact issue.

  15. Feel better, Stossel! We need you to keep fighting the good fight!

  16. Good luck Mr Stossel! I hope you beat this thing!

  17. Hey, John, get well, bro. We all appreciate everything you do and need you to keep doing it for a very long time.

  18. Well that sucks ass. Get well soon John – we need you more than ever.

  19. Have I mentioned I like Stossel?
    (Even with his decreased lung capacity)

    Seriously, John, get well. No one can operate the big scissors like you.

    1. Agreed. My like for Stossel will also be unaffected.

  20. Good luck John. You do a great service to our country with your reporting.

  21. Free trade agreements have decimated the base of American manufacturing by off-shoring jobs and factories, fueling the import of cheap foreign-made (and sometimes deadly) products. A free trade agreement is nothing more than trade heavily regulated by unaccountable regional governmental bodies that operate outside of the American judicial system. The global power elites view multilateral free trade agreements as one of their main vehicles for establishing, step by step, socialistic regional governments controlled by themselves as steppingstones toward a socialistic global government under the United Nations. Take action today to tell Congress to stop the Trans-Pacific Partnership, the Transatlantic Trade and Investment Partnership.
    http://www.jbs.org/issues-page…..ade-agenda

  22. Test test test

  23. John: Stop smoking and keep writing.
    God bless.

  24. Cool. As long as I can also tell the fat whiny oxycodone addicts to GTFO and take their fake complaints elsewhere.

  25. The Stoss is the boss. Keep on keeping on.

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  27. Mr. Stossel, although I don’t know you personally, I wish you the best in your ongoing recovery. I very much appreciate the work you’ve done over the years, and hope to continue to see your work for years to come!

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  29. Well, fuck. Why is it always the John Stossels and never the Dave Weigels of the world?

    Get well soon, Mr. Stossel. You’re the real deal, and one of the best going.

  30. You’re the man John! If you haven’t seen a respiratory therapist yet, make sure you do following your lobectomy. The procedure is likely to knock you on your ass, but consistently using a flutter valve and incentive spirometer afterword will help keep your alveoli open to maximize your gas exchange (O2/CO2.)

  31. Get well soon, John. I hope you fare better than I, a physician in the system.

    I was ignored when I complained something was not right in the hospital for rehab of the injury that I suffered when I broke my back. They ignored me. Turns out, my Hgb had dropped to half its normal level. I was complaining that something was wrong. They did not listen until I looked like I had a seizure after a PT session!

    Now, I only have to deal with inadequate pain treatment four years after my injury! Ironically, I was a trained pain management doctor, eliminated from medical practice by the competition!

  32. Re questioning the double-talk,or triple- talk above described, one is likely to get more or less the following “answer”. Move Along ,Nothing To See Here.

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  37. Best of luck on this, Stoss.

  38. In any enterprise, survival dictates that we please the person (or entity) who is paying us. Our rationale: If we don’t get paid, we can’t stay in business and do the good work that we do.

    The result is that I trim face-to-face time from my patients in order to make time to complete that patient’s paperwork.

    I’d much prefer patient satisfaction to bureaucrat satisfaction.

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