Hospital Costs in the Health Care Equation

First: a disclaimer. I’m not an expert on hospital costs, having been in one only four times in my life of over six decades. Three of these were for childbirths, hardly conditions of illness. I was treated well in each case. But I was intrigued by Prognosis: Profits, a recent investigative series on some North Carolina hospital costs by journalists Joseph Neff, Ames Alexander and Karen Garloch.

The conclusion of this series was that some prestigious local hospitals are hugely profitable. They drive up the cost of health care in hidden, even alarming ways. (Reasonable rebuttals from the hospitals were also included. More on that.) The first article, Major Hospitals Pile Up the Cash, claimed that Duke University Health System and UNC Hospitals have earned record profits, with Duke’s increase a whopping 20.1 percent including investment income. Prices of drugs and procedures are reportedly from three to 10 times the actual cost. Inflated salaries for executives are common in these hospitals, with twenty-five executives of NC non-profit and public hospitals compensated by more than $1 million each in 2010 and 2011. (One earned over $4 million.)

But the hospitals have a say as well. Costs increase for the average patient because hospitals have to cover the difference when some patients don’t pay at all, they say, and when Medicare and Medicaid reimbursements from the government fall short of the true cost of the services. This cost shifting is one factor affecting one’s final bill, but another is the competition among hospitals to provide more sophisticated equipment and technology, all costly, a demand that is partly patient driven. Non-profit hospitals like Duke and UNC systems are not businesses, so they can’t return dividends to their investors, but instead must plow profits into new procedures, facilities and equipment to meet the coming onslaught of those needing care. Hospital representatives add that they are profitable because they operate efficiently.

There’s so much more. If you can’t wrap your head around it, let’s change the focus and offer some hope. In 1972 our third baby was about to be born, and the plan was a caesarean section because our previous child had been born that way. Just before the operation was to begin, however, our daughter made her appearance quickly and naturally. What had happened? I had spent this pregnancy in daily dedicated prayer, supported by the specific prayers of an experienced Christian Science practitioner. Together, we sought more calm, more expectancy of good, and more harmony from a higher source than mere human wisdom or expertise. The medical staff rejoiced with us over the outcome, having never witnessed a natural birth after an earlier caesarean. Ten years later, the New York Times published an article about the medical community’s acceptance of natural births as possible after caesareans.

The birth was wonderful for a healthy mother and baby. Without surgery or drugs, the hospital cost was far less. Most of all, the transformative nature of prayer could be felt in that operating room and after when nurses from across the hospital came to visit us, the “miracle” patients.

I don’t presume to judge others’ decisions in this kind of case, or any other. Reasons for surgery vary and are based on serving the needs of the patient. But prayer has a role to play in every health care decision, if one wants to rely on it.

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