Monday, May 17, 2010

What Health Reform Hath Brought

Looks like hospitals still see nothing but green pastures now that health reform has passed:
"As we push our envelope to take better care of patients, it will push other hospitals to do the same, and in the end patients will benefit," said Dr. Tom McRae, cardiologist and managing partner of Centennial Heart Center.
I'm sorry, good doctor, but I wonder if we'll ever realize that this "build it, bigger, better and they will come" mentality will soon bite us all in the butt when the bill comes due. Sadly, they're not the only ones:
Other area hospitals have seen similar growth, pushing each to expand heart-care services. Tennessee has the sixth-highest rate of heart disease mortality in the country, according to the Centers for Disease Control and Prevention, which used 2006 data. (eds note: nothing like making projections on old data) About 233 people died for every 100,000 people.

Vanderbilt University Medical Center's Heart and Vascular Institute had 9,800 outpatient visits for cardiac care in 1998. Today, that number stands at about 80,000 outpatient visits among the main hospital, off-site clinics and 100 Oaks, said Dr. Keith Churchwell, executive director and chief medical officer. Vanderbilt also increased the number of cardiac critical care beds from 27 to more than 50 about six months ago. "Cardiology is an area of medicine that continues to evolve very quickly, and the types of rooms we built for procedures 10 years ago are too small to do what we want to do," Churchwell said. "We're constantly assessing."

Saint Thomas Health Service boasts 60 cardiac specialists between Saint Thomas and Baptist, and it has a network of 14 hospitals and 22 clinics in the Middle Tennessee and southern Kentucky regions. The heart patient population is only going to get bigger as the baby boomers enter their silver years, pushing the demand for services even higher, said Dr. Howard Walpole, chief of cardiac science for Saint Thomas Heart.
What me worry, right? It's so nice to reassure ourselves that such construction is in the best interest of our patients! Like Greece, it's always good to reassure ourselves that the health care spending party will never end.

Never mind that the CBO has just reported that we're already $115 Billion over budget on the originally passed health care reform budget before we even get started.



Donald Tex Bryant said...

You are right about Build It and They Will Come. I prefer to use my own knowledge and the care of my PCP to monitor my heart health. My PCP keeps close track of my blood pressure and suggests occasional tests to monitor the health of my heart and vascular system. For instance, last summer I went to a vascular surgeons clinic when they were having one of their quarterly specials for using ultrasound to assess vascular health. My PCP commented on it at my last physical.

I also use a variety of exercises to improve cardio health. Seems to work as I have a very low resting heart rate.

Keith said...

The health system has expanded to the point that we can no longer afford (at least many of us) the health system we have created. It will now come down to pieces of the health system competing for the non expanding pie. The only other means of extracting cost savings is to eliminate wasteful procedures and tests.

Each piece of the health care system points to the other as the place to extract these cost savings, but I suspect you and I know the waste exists at every level and piece of this bloated system. The most telling part is that patient outcomes seem to be worse where there is an overabundance of specialists, likely due to a competitive enviorment resulting in overuse of technology and procedures that may do more harm than good in certain situations.

That is why we need comparitive outcomes research to tell us what things work and which don't from the perspective of cost and outcome. Hopefully this will trim the budgets of hospitals (and specialists) resulting in cost pressure that will force them to stop building medical Taj Mahals.

Anonymous said...

I'm not surprised the hospitals are looking forward to green pastures in the short/medium run. Potentially competing physician-owned hospitals have been stopped in their tracks, but more importantly hospitals are the only segment of the health industry exempt from cuts under the new Medicare IPAB, at least for the first several years. You're right on the long-term sustainability of the current system, but for the next few years, hospitals are set.