Lifted from the comments:
Well, it’s not scientifically valid, but I did have dinner last weekend with a friend who is a CEO of a 2000 person HC provider, and he would tell you that margins are being squeezed mercilessly. Overhead is enormous – 80% of his employees are NEITHER doctors NOR nurse-practitioners. Consolidation is going to come very fast, and a decade from now, there will be less than 100 healthcare providers in the United States.
Some remarks:
1. This prediction may be quite independent of whether Obamacare remains intact.
2. Higher education, too, has bloated overhead. Of course, that industry is not being squeezed mercilessly. Yet.
3. There was once an essay that began, “The traditional model of medical delivery, in which the doctor is trained, respected, and compensated as an independent craftsman, is anachronistic.”
An apparently low % of MDs and NPs is NOT shocking but is normal. One hospital I work in has 1100 employees, of which 850 are nurses. No, the rest aren’t administrators. MDs, NPs, physios, pharmacists, etc. I respectfully caution the commenter against making such observations (independent of what he heard about overhead and margins) without checking what’s normal. In almost any hospital, the great majority of staff are nurses.
Many rent-seekers would love to see a hospital employing high percentages of MDs and NPs, or high %s of professionals mandated to have unnecessary advanced degrees. Is there not a US state that requires physiotherapists to hold doctorates to be licensed?
“Unnecessary diagnostic testing” is nothing. Hiring someone or paying them consulting fees is much, much more expensive.
Your subject line led my mind in a different direction than the blog post.
I would *love* it if reasonable medical coverage were provided the same way as McDonalds hamburgers. You don’t need socialized food in a world with McDonalds and Kroger — the vast majority of people just get a job and then go purchase the food they need.
Would that it were the same for the majority of medical analysis and medical treatment.
seiko ものまね