Saturday, November 17, 2012

The little hospital that does

Reason TV produced this video about a hospital in Oklahoma. What is unique about this hospital is it accepts payments only in cash. No Medicare, non Medicaid, and no insurance plans. The result is the charges for services are much lower than other hospitals.



Karl Denninger had this to say about the hospital at The Market Ticker:

That's right -- money. Now. Up front. Actual cash or a cashier's check. That's it. No credit cards, no checks, no "I'll pay you laters", nothing of the sort. Fork up the money, get the service.

They also expose their infection rate. It is a tiny fraction of the national average. In other words, they "do it right" and thus your risk of contracting an infection in their facility is lower. Much lower.

So what does this do to the cost of medical care? I'm glad you asked.

First, there is a $200 consultation fee. If you are not recommend for surgery, or decide not to have it, that's the bill. If you decide to go ahead, that is applied to your procedure.

Let's take an example.

"Open reduction internal fixation" -- that is, an open fracture that has to be repaired with screws, a plate, or similar. Their price: $4,455.00 for the entire thing, except for the hardware which is provided at actual, invoiced cost -- no mark-up.

Now there's a person on my forum who happened to need this surgery performed rececntly. He was on a HSA so he saw the entire bill. It was $25,000.

His girlfriend had a cervical disc fusion, two levels -- $150,000. Their price is $21,500.

Another user on the forum had a Lumbar Laminectomy performed and the bill was over $50,000. Their price? $9,900.

A few other examples:...

Getting the idea yet?

Sure, it's expensive to have an operation.

But these are the sorts of costs that you could go take a loan out for against your house or even car, or in many cases just take a cash advance on your credit card!

This is typically 1/5th of what you "pay" now. Or, if you prefer, 80% off. And this is the entire deal -- including the surgeon and anesthesiologist.

Do you know why?

Because they don't have to treat people who can't pay or don't pay. They don't have to take Medicare or Medicaid and have the government tell them they'll pay $500 for a procedure that costs them $5,000 to perform. And they don't have to treat Juanita the illegal Mexican, unless she has money
.."

It might be nice to create something like this hospital in Mississippi as Jackson is within short driving distance of New Orleans, Memphis, Birmingham, and Baton Rouge. However, that would be impossible thanks to the certificate of need law. One day we will have to blow up that little statute.

Oh wait, turns out Obamacare stops innovations such as this hospital:

"Physician hospital organizations are firing back at President Obama’s health care law in the press and the courts, seeking a repeal of what they argue are “exclusionary and unconstitutional” restrictions.

Section 6001 of the health care law effectively bans new physician-owned hospitals (POHs) from starting up, and it keeps existing ones from expanding. It has already halted the development of 24 new physician-owned hospitals and forced an additional 47 to struggle to meet the deadline to complete construction, according to the Physician Hospitals of America (PHA)
." Article

Unfortunately for such hospitals, the Eastern U.S. District Court of Texas ruled Section 6001 is constitutional. The plaintiffs appealed to the Fifth Circuit Court of Appeals. The court vacated the district court's judgement but ruled the court had no jurisdiction over the lawsuit. The case involved decisions made by DHHS under the Medicare Act. Thus the plaintiffs had to exhaust their administrative remedies before they could attack the statute in court.

Section 6001.

18 comments:

Anonymous said...

this is amazing. another sign of what the able-bodied welfare/obamaphone class is accomplishing.

Anonymous said...

The tipping point is coming. It won't end well. There will be violence and death. History repeats.

Anonymous said...

1) How much uncompensated (i.e., "charity") care do they provide to their community in exchange for enjoying a non-profit status (if they are non-profit)?

2) How do they comply with EMTALA to avoid going to jail?

The effect on prices is incredible.

Shadowfax said...

The drug trade is thriving too. It's also a cash-only business.

Anonymous said...

Many doctors don't take insurance now. It is impossible to find a dermatologist in the area that takes insurance. Plastic surgery isn't covered by insurance.
The costs for their services are not less than going to other doctors and $200 for an initial visit with the doctors in this piece is hardly cheap.

What should be asked is why they can charge so much less? The salary of someone to file insurance for them doesn't explain the difference. The charge on credit cards doesn't explain the difference.

The difference is not charging the patient for all of those who aren't insured and don't pay.

Now consider that very few people in this Nation can pay the costs listed here out of pocket.

Whatcha going do? Let children who need surgery die because their parents aren't wealthy? Try to raise $21000 from the local church?

And, I want to know if these doctors ever got a student loan from the government.



Anonymous said...

um, freedom of speech is thriving too 6:55am.... thats why you can say such stupid things...

Anonymous said...

To 7:13
What you are saying is if they 'took' a student loan, that they are owned by the 'commune' and 'didn't build that"? Ultimately, what you are saying is because you need or want it someone else should have to subsidize it for you or someone else. Medicine is a commodity though no one wants to see it this way. If you are a 'plumber' who went to Junior Tech school and took out a student loan, should you have to 'give' your services away to the pooour who can not afford to pay your hourly (in the north Union) rate? Of course not, you don't charge 5x the going rate to some give services away to others. To the legal beagles who 'one call' their way to building mansions, do you think we should have Nationalized legal Care? I mean, everyone needs an ambulance chaser now that we all have 'access' to the future hellcare? But, I remember a time when people actually went to the doctor WHEN they were sick, PAID their BILL and KNEW what the cost was, not What their Co Pay was and if it was on the "Card' (as in medicaid). Those were the good ole days of self responsibility, paying your bill and yes, if your child needed 21,000 for a surgery, setting up a payment plan and ACTUALLY PAYING THE BILL.
But, it is nice to have finally reached the 51% of people who are TAKERS, and within 7:13s lifetime, you will get to see the HELLCare system as it unfolds. Good luck!

Anonymous said...

I'm saying I subsidized their education.
Medicine has become a business and commodity but it use to be a profession. The law use to be a profession . And the professionals understood that they had an obligation larger than the almighty dollar.
Plumbing is a trade, not a profession.
And, professionals did not wear hair shirts and live in poverty when they didn't put money as the raison d'etre.
When your minister conducted your last rites, he knew your name .
We once understood the difference between a business and profession and trade, but now that we worship money and live in the moment rather than take a long view of what matters in life, your diatribe is what we get 8:47 am.
Some of us remember what life was like before too many Americans bought into the insane notion that money should determine every decision.
We now know the cost of everything and the value of nothing.

Anonymous said...

8:47 am medicine is a matter of life and death and health. The law is a matter of liberty and equality.
Plumbing is a convenience.
That you would put these vocations on the same plane of importance to a functioning society makes me seriously hope you are not a physician.
I suppose you think Jonas Salk an idiot.

Anonymous said...

8:47 here, but the "tort" reform opposition says legal access to millions is a matter of life and death too! But as far as clean water being a convenience, tell that to the pooour sic chil'ren who need it, and last I checked poo causes all kinds of illnesses., but with your diatribe you must live in the shallow gene pool of "professionals" in law or academics or a gubment employment.
And since those who are "subsidized" owe you and I something, how many Obama phone people can I expect you to bring over for yard work? I mean , they do realize they "owe" more to the collective right?
Law is not a matter of liberty and equality, liberty is God given, but if you are a law leach you forgot both those words long ago. So if I am to understand, if you are 'Professional' you are required to give away your services? , but if you are an Obama phone person you get to be a professional taker with no responsibility to the "collective" except to be inventory for marches, rally's and voting? As I said, good luck in the future- one day soon the professionals you "require" to give away their services will give up and leave you to the groups who have no responsibility.

Anonymous said...

Everyone dies. Some too soon, some far past their quality-of-life years, some quickly, some with excruciating slowness. How did our society get to the point of clinging so desperately and expensively to the last gasp? And to the point of deciding that every breathing human deserves every last-ditch effort, and never mind the huge cost?

I have plenty of insurance, which will cover whatever I want done should a horrible illness strike. But I guarantee this: if it's got a bad prognosis, if it's gonna kill me sooner or later, and require expensive treatment just to buy me a few more months (or even years)---then I'll decline.

Why do people grasp so frantically at life? It's only worth living if you feel good---if you're in mortal agony, then, well, DIE already. If you are a Christian, you can anticipate Heaven, if you're not, you can anticipate the same oblivion you were in before birth. And in either case, your relatives won't have to change your diapers, hold church fund-raisers for your treatments, and wait for the inevitable end.

Anonymous said...

8:47 here again, I forgot to add I love Jonas Salk and his brothers music! I think they are AWESOME! Maybe they can do free concert and we can record it on our O Iphones, they won't mind will they? After all, the children there won't need wheels anymore because of their music, they can use their legs to DAANCE to the Forward theme music.

Anonymous said...

11:56, that is easy to say as someone who is obviously mad at the cost of taking care of the elderly, as am I. It is easy to blame the high cost of end of life care on the medical profession. Until the standard of care is changed to "we will do what is required until your benefits are maxed out" your doctors will try to save you to keep from getting litigated against by your family after you die. I am totally for going to the vet model of we can do what we can until you run out of funds, but I don't think the entitled public will stand for that. The ending of medical entitlements will have to include ending end of life measures for emotional reason as well. I am totally in agreement, but the medical and legal system are going to have to come to a better understanding in order for this to happen. A death panel will be needed and terminating end of life care in futile cases will have to be upheld as normal in court despite emotional pleas.

Shadowfax said...

7:24; you called my post stupid and asked why I would make it. The point is that being 'cash only' (the entire pivot point for this thread) is in and of itself of no value and by no means defines success or best practice.

Sometimes points are made that you just don't readily grasp.

Anonymous said...

8:47 pm Jonas Salk of the polio vaccine, which he made available to the nation for free. It ended the polio epidemic which was the horror of my childhood.

There is no " death panel". Please READ the bill, at least that section. Are you unaware that insurance companies currently can deny coverage for treatment that doctors recommend for their patients if they don't find them suitable?



Anonymous said...

11:44 pm
Plumbers aren't responsible for " clean water". They fix the water delivery system. They do not make sure the water is clean before it enters the system.

Liberty and freedom are protected by laws. God doesn't intervene when the police come arrest you or someone murders your loved one. God gave us talents and free choice and expects us to use them.

I certainly agree that the legal profession has become as money grubbing as the medical profession and that both have also expanded to include all sorts of extra costs into the process.

I actually remember when my personal physician made house calls and when a doctor would barter payment.

I remember that our family doctor knew the family medical history, treated everything from broken arms to kidney stones and sent us to specialists only when needed. Now, though every orthopedist should be able to deal with bones, I have to go to a specialist in wrists or shoulders etc. But, first, I have to see the physician's assistant before I see the physician.


I actually remember lawyers accepting barter for service as well. I remember lawyers in our town offering their services free when they felt an injustice being done.

I remember when ministers actually visited homes and knew every member of the congregation and felt that was essential to their ministry...they were to minister to the flock as their first priority...not build a personal empire. Now, when I go to a friend's funeral, it's rather obvious that the minister didn't know the person most of the time ( unless it was one of my wealthier friends) and is only repeating what the family members told him and often bungling THAT.

It's called integrity,honor and understanding that there are things more important than yourself and a buck. It's called leaving the place you live better than you found it. It's called being a good citizen and good neighbor.

I'm financially very successful. But, I did not do it alone. I had good parents who made sure I had the best they could give. I had great teachers and great family physician so I didn't die at age 5. I had mentors in my early career. I had first rate employees that supported me . I had happy clients that recommended me to others. I had family that helped when I couldn't be two places at once.

But, I have run into to people like you. You take the advice or the knowledge or opportunity given, use the tools others made and take credit for lower echelon work product, eat food prepared by someone else and wear clothes cleaned by someone else and then claim you are a " self-made" man as if you could have accomplished a damn thing in your bubble by yourself.

And, isn't it amazing that GE is functioning without Edison ?! The self-made men die and the company goes on. What a shocker!








Anonymous said...

Hey 8:19, 8:47 here,
Wow! You mean Jona Salk isn't one of the Jonas rothers? I mean , I am solo surprised ! I just heard them on the radio and could have sworn he was the lead bro', also, is Vaccine like Creed? If so I would love to hear them.
Secondly, maybe you could tell me what section the IARP is located in the health bill, that would be the Independent Advisory Review Panel , you know the one that is appointed and authorized to decided what is available or not. Also, if you are denied a treatment from an insurance company guess what? You can still get that treatment, just pay for it. But under Obmacare with the IARP you will not be allowed to receive what they deem unnecessary because THEY determine what policies and coverage is available.
By the way, matching wits with you is not fair, you are unarmed and therefore, dismissed.

Anonymous said...

Hey 8:55, 8:47 here,
Since you are soooo well off can I have some? I mean that is the new way to "success" right? I mean, you admit you didn't earn it( you admitted to being born with a silver spoon up your orifice, using slave labor, and fooling clients to pay you- you must have because you never said you had work product worth paying for).
Also, there won't be a ' lawyer or police there when a loved one is murdered. They only fill out a report AFTER the murder, if YOU are a responsible person YOU protect YOUR family, YOUR liberty and life. As a friend said if there is going to be a police report mine is going to be the evemnts recorded because the perp is going to be outlined in chalk, but with spoon you have I am sure you are one of the Fonderenites who believe during a home invasion all they needed is a goof teacher and mentor and they would be okay- kind of like trading places right Buffy?
PS I actually PAY people for the food prepared, PAY people for cleaning the clothes and as far as using a tool or knowledge that is what people with actual SKILLs and TALENTS do, take a hammer that is sitting on Bart or Buffy's silver platter and actually MAKE something! But you Buffy's say, "hey, that was my hammer sitting ther, how did you do that? You owe me and society the fruit of your labor. Well Tonto, soon you wil. Have alllll that advice, knowledge and tools sitting on your silver night stand and with your lack of talent it will sit there.
You qualify as dueling wits with an unarmed opponent as well, who,would take credit for lower echelon work credit except a Buffy like,you.
Soon, we will see if you can tell which end of the hammer does what.
Your dismissed.



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