Obamacare Ends Construction of Doctor-Owned Hospitals

The Weekly Standard ^ | Jan 3, 2011 | JEFFREY H. ANDERSON

[george76]

Physician Hospitals of America says that construction had to stop at 45 hospitals nationwide or they would not be able to bill Medicare for treatments." Stopping construction at doctor-owned hospitals might not seem like the best way to boost the economy or to promote greater access and choice in health care, but that exactly what Obamacare is doing.

"Section 6001 of the health care law effectively bans new physician-owned hospitals (POHs) from starting up, and it keeps existing ones from expanding."

American Hospital Association ... the AHA, along with Sen. [Max] Baucus (D-MT) and Congressman Pete Stark (D-CA), are responsible for the language in Section 6001...

[A Strict Constructionist]

“Heaven forbid a Doctor should be allowed ownership in a hospital. That might lead to things like pride, improved service, and innovation.”

I believe in the free market but doc owned hospitals are run the same way as any other for profit. The profit comes first.

[BuckeyeTexan]

Well of course they’re run to make a profit. But doctor-owned hospitals are usually much cleaner (at least in Texas) and the docs on the Board get to set hospital policy. Docs setting policy is good for patients.

[HKMk23]

Is this part of Obama’s laser focus on”jobs, jobs, jobs”?

THE UNION BOYS OUGHT TO TAKE NOTE: Congressman Fortney “Pete” Stark (RAT-CA) done ‘em all dirty on this one.

RULE: Among leftists; your “Friend” is only your “Friend” until someone with more money shows up at the party.

All those pro-democrat union stooges just got punked by two ‘rats shilling for the American Hospital Association.

[Gabrial]

“But doctor-owned hospitals are usually much cleaner (at least in Texas) and the docs on the Board get to set hospital policy. Docs setting policy is good for patients.”

Texas has the largest number at 61. The nurse to patient ratio is significantly higher on the average at these institutions. They also tend to get higher quality of care ratings from independent rating agencies.

Democrats are generally against these institutions, which is why they effectively banned them in the Obamacare bill.

The main argument is the claim that doctor-owned hospitals slough off uninsured patients, who invariably end up in the emergency rooms of nonprofit hospitals. Those hospitals, facing an exodus of insured patients, may find it hard to stay afloat since they can't balance the cost of treating the uninsured with profits from performing procedures on the insured.

[A Strict Constructionist]

“But doctor-owned hospitals are usually much cleaner (at least in Texas) and the docs on the Board get to set hospital policy. Docs setting policy is good for patients.”

It depends on the hospital, most have docs on the board. I personally like the Mayo model.

[voicereason]

Looks like a perfect reason for doctors to stand up and say that Obamacare violates “interstate commerce” laws by prohibiting the building of a facility that can be used by anyone.

[PLMerite]

“I believe in the free market but doc owned hospitals are run the same way as any other for profit. The profit comes first.”

And with Obamacare after a very short while the object will be to save a buck. Would you rather be doctored by someone who’s trying to make an honest living or by someone who’s been ordered to cut costs, with the power of law and the full weight of the gov’t on his side ?

[therut]

There is a physician owned cardiac hospital in Arkansas. I try and send all my patients there. If I have a heart problem that is where I am going. They are efficient and have the best nurses. The physicians I talke to are polite and I can call them on their personal phones 24/7 365 days a year and they automatically take the patient. Does not matter if they have insurance or not. Of coarse the other hospitals hate them. They even sued them and lost. I know where I will go if I ever need cardiac care. Best hospital in Arkansas.

[newzjunkey]

You have to think that $44,000, and similar outrageous charges, are a lie. If they’ll settle for $5,000, you have to think it’s closer to the real cost.

[Chode]

yes, that's all they pay...

this is roughly how it works out for surgeons, now apply the same formula to hospitals…

Insurance Payouts

As an example, take a Diagnostic Laparoscopy with a true value of $1500

First tier insurance companies will all agree the value is $1500, but…

Their negotiated rate will include a combined adjustment/write off of ~$500 because there is a high volume of patients with their insurance in your area.
Pay out = $1000

Medicare on the other hand will say - No, it’s NOT worth $1500, it’s only worth $1000

And you will take an adjustment/write off of ~$250.
Pay out = $750

Medicaid says, We DON’T CARE what it costs… we are paying you $500.
Pay out = $500

[supercat]

I believe in the free market but doc owned hospitals are run the same way as any other for profit. The profit comes first.

Indeed. And in a properly functioning marketplace, how does one profit? By things like pride, quality service, and innovation.

To be sure, there are many ways in which government rules and regulations have changed the health-care system away from being a properly-functioning marketplace, but the solution is not to shift things even further from one. Rather, the solution is to shift things toward a model where services are allocated based on people's willingness to pay for them.

If a doctor has time to treat one of two patients for some condition, and patient #1 would rather have $500 cash than receive the treatment, while patient #2 would rather give up $1,000 cash than go without treatment, having the doctor treat patient #2 would be a far more efficient outcome than having him treat patient #1. If patient #2 gave $667 to patient #1, and gave $167 more to the doctor for treating him than he would get for treating patient #1, then patient #1 would get $667 for a treatment he would have gladly surrendered for $500, the doctor would get $167 more than he otherwise would have gotten, and patient #2 would only have to pay $834 to get a treatment for which he would have gladly paid $1,000. Having the doctor treat patient #2 instead of patient #1 would be a win for everyone.

[Ragnar54]

So, a drug dealer or a lawyer or even a politician is allowed to own a hospital, but not a physician? Yours is a typical RINO argument for getting along with the statists.

It is always possible to come up with "pragmatic" reasons why free enterprise does not work in the current environment. This always boils down to the need for the nanny state to "protect" people from making stupid economic choices (or somehow being preyed upon by evil capitalists). By your reasoning, the government should make all economic decisions for us (since only the enlightened, benevolent government knows best).

Even if it were true that patients and insurance companies are so stupid as to always make the wrong choices in purchasing health care (or anything else, for that matter), there would still be no justification for preventing law abiding citizens from owning a legitimate business.

Given your statist sympathies, you should probably consider moving over to DU.

[neverdem]

War On Doctors

Obamacare needs to be repealed, badly.

[A Strict Constructionist]

“Indeed. And in a properly functioning marketplace, how does one profit? By things like pride, quality service, and innovation.”

The only problem is that we have a limited supply of docs. I agree with your argument but we need to increase the supply of docs for it to work. There is no need for competition now. They all charge the same excessive prices.

[A Strict Constructionist]

“by someone who’s been ordered to cut costs, with the power of law and the full weight of the gov’t on his side”

The insurance companies have been doing that for quite a while. I prefer for the service to be done logically and for the benefit of the patient.

[mo]

Its called “Accountable Care Organizations”

http://www.kaiserhealthnews.org/daily-reports/2010/november/30/health-care-models.aspx

And, no, your doctor doesn’t “know” enough about “how to run a hospital” like they do.

Welcome to the Fascist Fifty States of America.

[veritas2002]

If I were a physician, I would be gathering other doctors and investors to set up off-shore clinics and hospitals where American could go for elective surgery. Take a place like Belize or some beautiful island country that needs the revenue. Set up regional hubs in the US where preliminary lab tests, x-rays, etc could be performed, but do the surgery at some idland resort without all the encumbrances of government regulations. What would be better if you are having coronary by-pass, knee or hip replacements or some other procedures than to combine it with a nice tropical vacation for a few weeks in resort-like fashion. What everyone needs to do is find ‘end-runs’ around the govt loonies.
Doctors, nurses and other technical medical personnel could take short flights to this island clinic and work in a vacation-like atmosphere - away from Obama and his nightmare healthcare destruction act.

[PLMerite]

“The insurance companies have been doing that for quite a while. I prefer for the service to be done logically and for the benefit of the patient.”

That’s not the choice you’re going to have. It’ll be like Canada - their way or the highway.

[A Strict Constructionist]

“That’s not the choice you’re going to have.”

I know that and don’t want government control. I thought we were discussing doc owned hospitals.

[MrB]

The profit motive leads to the best service.
This has been proven repeatedly in the marketplace.

The doctors could try to squeeze out a few bucks by providing inferior service,
or they could provide superior service for a competitive price and attract more customers.

The second method provides the best profit, and a profit motivated hospital would follow this model or go bust.