The wealth of hospitals

it’s probably because birthing services are more likely to be Medicaid than Medicare

Hospitals are the richest places around. They don’t need our sympathy. They can always refuse to take Medicaid, can’t they?

Holy shit, not the hospital my father worked it. It was always tottering on the verge of financial catastrophe. It’s a good hospital, but it’s located in the midst of some poor neighborhoods, and gets a lot of underfunded patients.

I don’t know what the rules are about taking Medicaid. This one was legally not-for-profit, and couldn’t turn away Medicaid patients. I remember they did used to check and see if a patient was a veteran, though, because they could legally transfer veterans to the VA hospital, which wasn’t as good a hospital, but was legally “good enough”. I think a lot of their most costly patients were sent to the VA.


Being not-for-profit is a choice too, and being not-for-profit doesn’t stop administrators from paying themselves high salaries.


they can for scheduled things, yes. perhaps not all hospitals can, but it is possible in general.

For a patient entering through the emergency department, they can’t refuse to treat or initiate transfer until the patient is stabilized.

that’s been my understanding, but it is possible i am wrong

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emergency treatment is often very minimal. Chemotherapy, for example, is not emergency treatment. Even if the patient would die without it.

Tell me you don’t work in healthcare without saying you don’t work in healthcare.

But this is true.


A place that keeps itself poor by paying its employees high salaries is just playing a shell game. Hospitals are rich and pay regular dividends to their owners (aka their employees). Not having money because they pay employees high salaries doesn’t mean they’re not rich.

Tangent: My emergency department pharmacy bill for post exposure prophylactic treatment for rabies was way more than a friend’s chemotherapy infusion.

The bill, yes. How much was the actual cost to the hospital of providing the care?

Yet another shell game hospitals play - we don’t tell you the actual cost of things and somehow a $50 tylenol seems low.

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Resiliency pizza only goes so far for medical staff.

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Poor heroic medical staff, forced to live on an average salary of >$300,000 plus some lousy pizza.

(Of course, not all hospital employees make loads. But the ones with the power do.)

Because physician specialists are the only people employed by a hospital.


Let’s subsidize more med school, cover malpractice, and lower Dr. pay.


I’m not saying they are. But my point about hospitals being rich but hiding the fact by paying their administrators and doctors loads still stands.

That statement is a heaping pile of crap but you’re welcome to stand in it.


Yup. Increase the supply of doctors. But that doesn’t solve the hospital administrator issue. That one needs to be solved by treating hospitals like the monopolistic entities they are.

I see we’ve got to the part of the conversation where there’s nothing to say.

But seriously, didn’t you agree about the administrators? Why are you so emotionally linked to hospitals? Is a family member a doctor or something?

Yes, your system is very different from ours. We don’t have rich nor poor hospitals nor is there any concept of making a profit on medical services.

The hospital in a poor district, like any other hospital, sets its budget for the year for the services it wants to provide and requests funding from its province via its governing health authority. The request is reviewed thoroughly and suitable block funding provided. A poor person in the hospital catchment area has the same access as a rich person: no insurance issues.

My mom worked as a hospital administrator for a while. (Different hospital, conflict of interest and skill that.) She earned a lot less than i make as an actuary, even if you adjust for inflation.

Yes, doctors in the US are paid more than doctors in most other countries. And we pay enormously more for drugs than any other country. And we waste enormously more money on administration (by which i mean checking to see what’s covered, who is covered, which treatments are allowed by this patient’s plan… All done by very middle-class people, but a hell of a lot of them) than any other country.

That doesn’t make “hospitals” rich. By and large they aren’t.

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Hospitals can’t be rich because they want to be classified as nonprofit. Being nonprofit comes with some pretty good perks, such as being tax exempt and such as medical students having their debt forgiven.

But! they pay their employees lots of money. (Some of them, not all of them. Just like Amazon doesn’t pay their lowest rung employees that much either. Or Apple.)

In my view, the 2 above points make them rich but hiding that they are. A poor business doesn’t pay their employees high salaries. That just doesn’t make any sense.

Sounds like your mom was an administrator, but probably not one with the power. I’m guessing most women at the time didn’t have much power. That doesn’t contradict what I’ve been saying.