Where is money wasted in healthcare?

DeepFriedRN · Jul 8, 2009

Sorry- the real crux of my argument with you is your arbitrary decision of basing someones LIFE on whether they are "existing" vs "living". There are many ways to justify this "saving of money", and each one is as zany as the last. Should we select people who don't contribute to society? Should we pick people who are going to die anyway? Should we pick people who have serious diseases? Should we only pick the poor people?
Please don't fall into the thinking that money is more important than life itself. What benefits a person if they gain the world, but lose their soul? The money you save anyway will not go toward anything good; it will simply make rich people richer. Which doesn't include you or me.
The problem with your argument is that you assume these people are LIVING. The people I think Shay is referring to, their bodies are doing the best they can to die, which is the natural course for each and every one of us. If their bodies had their way, these people would have already passed. Going to these extreme measures to keep their bodies alive is the "arbitrary decision" being made, WE have decided that they are GOING to live, no matter what it takes. It's not always about the monetary cost, either. The process of drawing out someone's death in this manner is draining in others ways, as well. Mostly for the body that we're doing it to.

RN Randy · Jul 8, 2009

What would be the cutoff age for aggressively trying to save a life rather than letting nature take its course? Have we not seen miracle patients come back from what we thought were impossible odds?
In Europe I believe they start adult cut-off ages around 65 and go from there, depending on Dx.
Not so much cut off of care, but of funding for said care, which usually results in cut off of care....?
As for Corporate America,
The only hope for the US health system is a prayer that we can revamp it correctly after the collapse.

DeepFriedRN · Jul 8, 2009

Concentration camp survivors existed. Would you have preferred them all to have died?
I would just like to ask who will be deciding who lives and who dies. The insurance company?
Also, I see SCI patients with a high cervical injury, all with a vent and no chance for recovery. These people are little more than heads, with no ability to move, and will ultimately cost far more than a 95 year old on a vent. Should they be "allowed to die"? Many other people are included in your "existing vs living" analogy.
Be offended all you want. Deciding who should live and who should die all to save money, comparatively meaningless bits of paper, is inhuman.
And to address this, I'd just like to add--if these cervical injury patients who are vented are alert and oriented, then they DO still have a chance for a meaningful life. They can still laugh at a joke, read or tell a story, think, share. It's not the same life you or I will live, but it can still have meaning. I, for one, find it "inhuman" to keep a body that is trying to die, alive. If someone is dying, they are dying. It's not abitrary, it's a fact.
You know, my mom used to say something to me when I was a teenager. (Usually in reference to my too-short skirt, LOL). She said, "Darlin', just because you can, doesn't mean you should." I think that is true in so many situations in life, this included.

dotherightthing · Jul 8, 2009

some time ago, i took a week-long class in a process called "six sigma", which began in industry and has now migrated over to health care. officially, it is known as a "process improvement" effort, but long story short it's about cutting costs and saving money. the six sigma process was designed by engineers, so it takes months and months of measuring, graphing and data collection to get the end result. i'm a "cut to the chase" kinda girl, so would love to hear where other nurses are seeing wastefullneess in health care. big things, small things, whatever.

may as well start with the smaller stuff. i don't remember the cost of the last band aids i bought but i can assure you that one band aid didn't cost 5 bucks or $1.00. $5.00 for a box of 30, maybe, which breaks down to about 17 cents per band aid-so charge $.25 then or $.50 then. charge near the real price for an item or service, build in some reasonable amount for the uninsured, but don't budget for a hospital president's $12 million per year salary. or $2 million for that matter. if an mri machine costs $150,000 to build, don't charge $1 million for it. these are the kinds of things that drive up the cost and each consumer, whether it's the hospital buying an mri to the person who needs the test.....each is being held hostage by the need. and don't even mention the insurance companies who are working based strictly on numbers,not the individuals who need a service. give every person health care and see how easily prices come down.

RN Randy · Jul 8, 2009

Concentration camp survivors existed. Would you have preferred them all to have died?
I would just like to ask who will be deciding who lives and who dies. The insurance company?
Also, I see SCI patients with a high cervical injury, all with a vent and no chance for recovery. These people are little more than heads, with no ability to move, and will ultimately cost far more than a 95 year old on a vent. Should they be "allowed to die"? Many other people are included in your "existing vs living" analogy.
Be offended all you want. Deciding who should live and who should die all to save money, comparatively meaningless bits of paper, is inhuman.
Wow thinker, what part of "hopeless case" are you not getting?
No one is saying there should be a decision of who lives and who dies, sheesh.
If your prognosis is zero then it's zero. The discussion is about keeping bodies stewing in the ICU.
Just because we can keep a zero-prognosis carcass alive long after it dies and even starts to rot, doesn't mean we should.
If I'm told I have 6 months to live r/t whatever disease, then I plan to have a really cool 6 months.
However; they say if they spend a simple 2 million on me, they can guarantee that I live another 3-4 months, so is it fair for me to suck up that 2 million that could have been spent on research for a cure to BILLIONS of people? Could have been spent on 200 other folks under age 18, that only needed 10 thousand each to get through the ER or ICU after the drunk hit them, to live on another 75yrs and become scientists that use someone else's 2 million to find the cure? Could have been spent on 2000 other people that only needed a doctor visit and run of antibiotics to live? Could have been spent on....... ?????
Who are you to decide who has to die because you think your way is the only way?
If you ever get the chance to come out of your expensive, sterilized world and visit people who are truly in need, people who are truly sick, people who's hope of life rests on a $4 injection they can't afford or even find... please do. You'll be so amazed at how blind you didn't know you were. You really *can* live without 75% of the stuff you *think* you need.
Wanna save money? Stop letting the water run non-stop when you don't have to. Stop leaving lights on. Stop letting equipment run in the corner if it isn't being used. Stop using disposables when you don't need them. Stop breaking open those kits to get a single item out because you're too lazy to go find what you need. Stop taking equipment/supplies home to operate on your cat. Stop running flyers for your little league team at work. Stop allowing others to 'live and let live' as *YOU* watch them waste the very money you're crying about here, while doing nothing about it. (etc, et al, ad nauseum)
Still though, if you find this magic money-tree that seems to be the root of your ideals, please tell us where it is.

howardrgreenberg · Jul 8, 2009

I haven't read many of the messages in this thread which has received a massive response, but I will say that waste and inefficiency in health care, re Paul Krugman (NYT columnist, Nobel laureate, MIT economist professor, etc) is in the insurance. As it is said, we have an insurance crisis, not a health care crisis. The 3d party system, e.g., the Blues, render the system massively redundant and inefficient. According to Paul, there is no need to ration and take other extreme measures. We need single-payer, to wit Medicare for all. That will not happen until the system kills the country's economy, because we don't act sans a massive crisis. And even then we might not act.

The reason little change will occur without a meltdown crisis is the baby boomers, Big Pharma and the AMA.

That is my two cents.

H

Ladybuggers · Jul 8, 2009

Vivacious1Healer...Say it honey! I could not agree more! :banghead:

AOx1 · Jul 8, 2009

It is wasted by hiring a concierge- we are a hospital, not a hotel. It is wasted by hiring the cheapest person who will do the job, even if they are not the best qualified, thus requiring others to go back and do the job properly on a semi-regular basis. It is wasted on the CEO and his "corporate retreats" to island locales. It is wasted on bottles of nice wines for the physicians (my husband works for a doc who just got a $100 bottle of wine and doesn't even drink). It is wasted on pretty lawn maintenance while some of the equipment in the ICU probably rivals me in age (would it be too much to ask for a Doppler that WORKS??). It is wasted in the physicians' lounge where there is always free and delicious food, fresh fruit, etc.

I can also tell you where it certainly is NOT wasted- in nursing and CNA salaries to provide adequate staffing ratios, in sitters to help keep suicidal patients or confused patients safe, or in education to truly ensure that the staff remains up-to-date on key items. It is NOT wasted in providing breaks nurses are legally entitled to, or to ensure adequate security to keep all staff safe.

lpnornot · Jul 8, 2009

Where is money wasted in healthcare? This is porbably small potatoes but I've experienced wasteful irresponsible behavior amoung seniors with medicare. If there was some monetory contribution to doctors visits that they had to make it would prob go a long way to curbing this problem. Examples:

-going over and over again to doctors with the same compliants but not actuallly following the medical advice given.

-you have a choice to spend a few dollars on an easly administered over the counter remedy but decide instead to go for the doctor visit and have the doctor perform the simple procedure BECAUSE ITS FREE, MEDICARE PAYS! With no regard for the tax payers who pay for this and how medicare is running out of money.

-Being incredibly non compliant, thereby racking up unneccessary bills for health conditions that could easily be controlled by following doctors advice on medication and or change in lifestyle-a healthy diet and exercise!

Crash_Cart · Jul 8, 2009

Because majority of nurses here was worked and lived JUST in US, well is hard to believe how the health care function and in other countries.
Trying to apply in US the health care model from another countries will not work at one point, because their model was adapted for their own needs and US is US!
The problem here in US are insurance companies between patients and providers, is the huge mistake ever.

I am from Canada and have worked in Canadian hospitals..

The "waste" I see here isn't "waste" ...It's the "costs" associated with the supplies and equipment used.

Basic equipment costs money and LOTS of it in the US. More than usual in fact... That's why health care costs so much money these days. It also explains the high cost of insurance to pay for it all. That is to say, insurance which 80 million people in this country are no longer willing to pay for. (Who can blame them?)

For example, there is absolutely no reason a band-aid should cost $10.00 or a suture needle should cost $200. Why does a Hill Rom hospital stretcher cost $15,000 each? Heck you could buy a small car or pay half the money down for a Hummer SUV !! It's just a hospital stretcher... right? lol

In the old days, a stretcher was a flat metal tub like slab, It had a rail around it, a frame with 4 legs was welded to it, it had a foam mattress and 4 wheels attached. Sounds like something you could build in your backyard for $150 bucks if you ask me. !!! It moved patients in the same exact way and it didn't move any slower than stretchers do today.

Is a colonoscope really worth $75,000 ?? Why? After all, it's just a rubber tube with a camera inside.. Honestly, is there any reason why these devices could not be manufactured any cheaper? Surely the parts to build one these can't be worth THAT much money... Can they incorporate my $25.00 webcam into a rubber tube to do the job? (lol joking)

Similarly, I can buy an electronic thermometer at the drug store for $10. Now if I buy one for use in a hospital it suddenly becomes a $700 device that does the same exact thing.. Same idea with electronic BP cuffs.

Perhaps the reason for the higher costs is because the drug store version is a BP cuff while the hospital version is a sphygmomanometer?

Why does 6 feet of nasal cannula cost $35.00 and yet 6 feet of fish tank tubing cost .99 cents?

Why does a light bulb for my ceiling fan cost $1.00 and a light bulb for an overhead examination lamp cost $300 each?

Any reason why they can't use autoclaves to sterilize equipment? ...Why all the high cost disposable plastic crap?

I have seen $300 trays thrown in the trash because someone only needed a pair of $30.00 plastic tweezers from them. ($1.50 if you buy the same tweezers in the drugstore.)

Then again, a hospital could purchase "metal" tweezers for $30.00, sterilizer it in an autoclave, and use the same pair of $30.00 tweezers over 5000 times! (Not to mention saving the environment from more disposable plastic trash.)

You mean to suggest that there are people who are actually perplexed, sitting there and they can't possibly understand why health care costs are through the roof? :uhoh3:

RN Randy · Jul 9, 2009

I haven't read many of the messages in this thread which has received a massive response, but I will say that waste and inefficiency in health care, re Paul Krugman (NYT columnist, Nobel laureate, MIT economist professor, etc) is in the insurance. As it is said, we have an insurance crisis, not a health care crisis. The 3d party system, e.g., the Blues, render the system massively redundant and inefficient. According to Paul, there is no need to ration and take other extreme measures. We need single-payer, to wit Medicare for all. That will not happen until the system kills the country's economy, because we don't act sans a massive crisis. And even then we might not act.
The reason little change will occur without a meltdown crisis is the baby boomers, Big Pharma and the AMA.
That is my two cents.
H

I'll agree with some of that... but I truly think backing up even further is where the problem lies... it's an "Americanization Crisis" ... the insurance crisis is a result of the American way of wasteful thinking/living in the first place.

If we didn't live in a disposable society, we wouldn't have disposable thinking.

I love my country, but I have to say that the "American Way" isn't very cost effective or very giving. It's a very expensive and selfish dollar-driven society in which we live.

As for the hint of universal healthcare, I'm not sure that's the answer either. Wrestling the tax monster is hard enough without giving him an ace in the hole... Can you imagine trying to get a tax break or cut when the opposition can rebut with "But you'll cut into the healthcare!!"

I barely manage to scrape 50 grand a year, and when I pay the government (State+Fed tax) $15,000 of that for the privilage of being a "free" member of the American Republic for which our flag stands, then add on the second of the 'one-two' punch take of taxes for say, just Medicare and fuel per year, runs it up another $3,800, then plus groceries, property tax, vehicle tax, gifts, estate tax, licenses for this/that, and whatever stuff I don't even know how to calculate, so I'll just round off my $3,800 to a lowly guess of $4,500 for a grand total of $19,500.

So that's about 20k per year, just to interact with this society, and I haven't even paid my bills, car payment, house payment, or bought food yet.

No.

Thanks.

And if that didn't hurt, imagine this. Just for sake, say only 1 million people in the USA work, and they only make $50k per year. With today's taxes, using the 20k above, that equates to 20 BILLION DOLLARS, just given to the lobster eaters in DC so they can use tax funded cars and dinners, wear tax-written-off suits, having their asses wiped by tax-written-off illegal alien maids/butlers, while using their $200,000 tax funded salaries for nothing but houses, whores, booze, bribes and kickbacks so they can do illegal favors for one another while they pick their teeth and form tax supported "American Car Buyer Prospectus" Committees to graph the overall tastes of the American car buyer.

Healthcare is just another line on the spreadsheet, that's all.

Now figure that the real number of people in the US making around 50k/year is more like 30 million....

That's $600 BILLION, or better said... over half a TRILLION dollars every year, from *maybe 24% of the taxpayers*.

You can add on the remaining percentage.

No wonder my welfare neighbors drive Lexus.

All I want outta life is for my kids to make it without struggling, and get a good education so they can do the same for their kids.

After that, an Electraglide Ultra and a small house on a lake or river would be nice, but not mandatory.... and I'm willing to work till I fall dead to have it, and leave it to my kids.

What are my chances? Pretty low if ya ask me.

Healthcare is the least of my worries. I'll spend my last dime in my last days to go live where all the missionaries and medical missions go, and be happy to be there; because those folks will care for each other before they will themselves, and I'll actually be getting some of my tax dollars back in a roundabout way.

Sorry for the rant...

rb

RN Randy · Jul 9, 2009

Why does 6 feet of nasal cannula cost $35.00 and yet 6 feet of fish tank tubing cost .99 cents?

LOL, that's easy. Because if you find some minor manufacturing defect in your tank tubing, such as a bump of plastic or simiar, your reaction will be "oh... well, it works so leave it."

However; should you find the same bump in your oxygen tubing, you will be able to easily locate a tubing-bump class action lawsuit to join in on, and claim millions from the manufacturer, so you can get your $8 payoff check that you deserve for the danger of having to drag that extra ten thousandth of a microgram weight on your 50ft tubing run out to the back porch smoking section.... or wherever... haha.

rb