re: Trigger Warning: UMC nurses in NO vote to unionize

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Is your claim that hospitals with non-unionized nurses charge less for services than unionized hospitals?

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That's no dumber than claiming that a CEO's salary drives healthcare costs up, but thank you for illustrating the obvious flaw in both of those positions.

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That's no dumber than claiming that a CEO's salary drives healthcare costs up,

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People who cannot do math.

As a teacher if you want to make over 100k, be a union organizer.

Thats where the real money is. Union leaders (most lowly educated) make bank.

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You said youve never managed unionized workers before, are you in for a surprise

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FMLA, call-ins and other absenteeism is about to go through the roof.

What drives up Healthcare costs is that most metro areas have what amounts to a oligarchy when it comes to hospitals, etc.

Most of the docs now are essentially employees of the system and instead of driving down costs they keep those costs high. I was talking to an old pathologist who said probably 1/3 of all lab tests done are essentially superfluous. It's CYA for the physician and hospital.....and they charge you for it.

The nurses in the hospital are abused routinely....but that is their job and they accept it because it is part of it. They deal with a-hole patients, a-hole family members and a-hole doctors and admins.....yet they do a lot of the work

I'm assuming you are dealing with truck/van drivers?

Nurses are different in that most want to be nurses.....whereas most drivers do not start off saying, "you know when I grow up I want to drive around all day delivering things"

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What drives up Healthcare costs is that most metro areas have what amounts to a oligarchy when it comes to hospitals, etc.

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Explain this please. I suspect it's because of the billions worth of uninsured care, fear of liabilty(the unneeded tests) and the hundreds of employees hired to monitor and satisfy Joint Commission and CMMS standards.

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What drives up Healthcare costs is that most metro areas have what amounts to a oligarchy when it comes to hospitals, etc.

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That is one factor, for sure. And it need not be a sizable metro area for this to be the case. We call the local hospital the "Medical Mafia" in our area and we're only talking about a population of about 140,000 people for the whole county.

But it's not the only factor.

What most of the mouth breathers on here crying about administration fail to realize is that—yeah, the administration as a whole DOES drive costs up—but they never think to ask themselves why hospital administration has skyrocketed over the past few decades.

The never-ending march of government regulation (which the vast majority of the complainers vote for every election) and third party pay. That's why.

And btw, "Medicare for all" is still a 3rd party paying the bills. It's not the customer nor the provider. So "Medicare for all" doesn't fix any problems that a 3rd party pay system has, and makes it worse b/c it removes any competition.

So your CEOs and hospital admin staff is a direct result of the government regulating everything to the point that someone has to be in charge of compliance for that regulation.

Here's some numbers for you. The numbers tell this story—If you vote Democrat, suck it and quit complaining about administrative bloat because you are the one who is causing it.

Numbers and Costs Tell a Startling Story

The AHA research picked apart the healthcare system to divide it into nine domains:

Quality reporting
New models of care/Value-Based Payment models
Meaningful use of electronic health records
Hospital conditions of participation (CoPs)
Program integrity
Fraud and abuse
Privacy and security
Post-acute care
Billing and coverage verification requirements

Within those, it found that health systems, hospitals, and post-acute care providers must comply with 629 discrete regulatory requirements. Those split almost evenly, with 342 oriented toward hospitals and 288 toward the post-acute system. The regulations are promulgated primarily by agencies: the Centers for Medicare & Medicaid Services (CMS), the Office of Inspector General (OIG), the Office for Civil Rights (OCR), and the Office of the National Coordinator for Health Information Technology (ONC). There are other federal agencies, however, who do have regulatory oversight (AHA, Regulatory Overload, 2017).

What does this mean out in the “real world?” A lot of time spent making sure that myriad data is not only tracked but documented and archived in such a way that it can be accessed for verification. That takes time, staff, and money. According to one summary of the report (Burke, 2017):

Health systems, hospitals, and post-acute providers collectively spend nearly $39 billion a year on the administrative activities related to regulatory compliance.
The regulatory burden equates to an average cost of $1,200 per patient admitted, or $47,000 per hospital bed, per year.
On an individual hospital basis, hospitals that are part of larger systems incurred a total of $5.1 million in costs per hospital, compared to $8 million for individual hospitals that were not part of a system.
Health systems, hospitals, and post-acute providers must comply with more than 600 discrete regulatory requirements with the greatest number found in the areas of: Conditions of Participation, Privacy and Security Rules, and Quality Reporting
An average-size hospital dedicates 59 employees to regulatory compliance.
Fraud and abuse requirements are outdated and have not evolved to support new models of care.

The AHA called out the frequency and pace of regulatory change as a major issue in compliance. By noting that “as new or updated regulations are issued, a provider must quickly mobilize clinical and non-clinical resources to decipher the regulations and then redesign, test, implement, and communicate new processes throughout the organization,” it showed how increasing regulation causes ongoing upheaval in the clinical setting as compliance is sought and achieved. The report also squared off against Meaningful Use, the rollout of which it says is requiring the average-sized hospital to spend nearly $760,000 annually to meet administrative requirements, as well as $411,000 in related upgrades to systems during that same 12-month period — 2.9 times more than IT investments for any other domain. (AHA, Regulatory Overload, 2017).

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The nurses in the hospital are abused routinely....but that is their job and they accept it because it is part of it. They deal with a-hole patients, a-hole family members and a-hole doctors and admins.....yet they do a lot of the work

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Also true, and I have no problem with nurses. That's not my argument.

I just think it's asinine to think that the people who run huge organizations like hospital systems are unnecessary.

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The never-ending march of government regulation (which the vast majority of the complainers vote for every election) and third party pay. That's why.

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Holy hell, this. I didn't read all 18 pages but I hope this wasn't the first time it was mentioned.