[muninn_]

> implying doctor’s don’t want 6-figure salaries

The manufacturing operations-ization of hospitals is both good and bad. Good because that means we have standard care (as desired by regulators and single-payer advocates) but bad because doctors lose the ability to perform customized care solutions.

I’m in favor of single-payer but we have to guard against turning healthcare into a manufacturing operation while also bouncing out bad actors and poo-quality physicians.

[aaavl2821]

The issue with hospitals controlling healthcare is that they are the group with the least incentive to lower the cost of care

Hospitals account for the largest chunk of healthcare spend (30%). Hospitals make money by increasing inpatient admissions, particularly for profitable surgeries. The standardization of care in hospitals is intended to maximize profit under the constraints of various regulations around readmissions penalties, reimbursement limited length of stay, etc. If you look at the financials of public hospital companies like HCA and Community Health and Tenet, their major metrics are growth in admissions and surgeries. Even non profit hospitals are driven by this

The expansion of hospitals into owning tons of formerly independent specialist and generalist physicians is scary. Once in a hospital's system, these physicians act as loss leaders funneling patients into the hospitals profit center

Having hospitals in charge of the healthcare system is like having a fox in charge of the proverbial chicken coop