Posted by: notdeaddinosaur | December 9, 2010

More Wasted Money

There was a series of ads on the radio a while back that went something like this:

When Mrs. Willis had a stroke, her husband never slept alone. Her daughter never had to go dress shopping for the prom by herself. And her son didn’t have to sit out the Mother-Son dance at his wedding. Why? Because she came to Hospital A…and she didn’t die!

There’s another set of ads for one of the big downtown hospital’s cancer center — sorry “Advanced Cancer Center”:

Every cancer; every stage. Your life depends on it!

Let’s see: no one ever dies at Hospital A. And the big downtown cancer center can cure any cancer. That’s certainly what those ads would have you believe. Even the little local suburban hospitals have taken to advertising: billboards around the neighborhoods; kiosks at the outlet malls, mainly pushing the lucrative stuff like cardiac care and bariatric surgery.

Every time I see this stuff, I can’t help but wonder how the hell much it all must cost. And how much medical care could have been provided to the uninsured, instead of enriching the ad execs and billboard owners who are already rolling in dough. Clearly there is still plenty of money to be made in the hospital business, because these people aren’t stupid. They wouldn’t spend this kind of money on marketing unless there was plenty more to be made from it. I believe it’s a little business concept known as “return on investment”.

Silly me. I still think of myself as being in the business of providing medical care, rather than just raking in the maximum number of dollars from each patient who darkens my doorway. When did hospitals lose all that?

Wouldn’t it be interesting if there were some way to re-direct even a fraction of the funds spent on medical marketing, diverting it to actual medical care instead? How many free clinics could be funded for the cost of a radio ad campaign? How many years of generic meds could be paid for with the cost of one billboard? How much suffering could be alleviated for the price of a kiosk at an upscale outlet mall?

I say let’s find out. Ban direct-to-consumer advertising by hospitals and doctors, and try instituting better tax incentives for providing charity care.

Then again, now that the Baby Boomers are aging, maybe the health systems will start advertising their superior end-of-life and palliative care programs. At least Hospital A may admit that people actually die.

 


Responses

  1. “I say let’s find out. Ban direct-to-consumer advertising by hospitals and doctors, and try instituting better tax incentives for providing charity care.”

    YESSS!!! I’ve written several essays on that premise. Also, I personally think that all the money pharma spends on TV ads should be redirected to researching NEW treatments/diseases (i.e. not just a variant on a competitor’s theme). In one essay, I proposed that a prestigious monetary award be developed (kinda like the Nobel Prize but on a smaller scale) that would be given annually to the pharmaceutical company or medical research team that developed the “best” new therapy that year. (“Best” being a complex scoring system determined by safety of treatment, “cure” rated higher than “manage symptoms,” additional points awarded for prevalence…and thus more potential worldwide benefit…, etc.) Yeah, it was an idealistic undergrad’s imaginings, and thus there are TONS of kinks to work out.

    But I absolutely, 100% support banning direct advertising and giving better tax incentives for charity care.

    I also support eliminating “wasteful” treatments and pushing for better access to preventative health care and giving incentives for healthy living (i.e. I’d rather give more money to someone, uninsured, with a costly illness that TAKES CARE of their body the best they can… eating right, not smoking/doing drugs/drinking excessive alcohol… than to a person that shoots up every night or smokes a pack a day or gets diabetes/CVD from their eating habits. I support their right to obtain pleasure at the expense of their body,…heck, even my dad would fit under that population description… and don’t get me wrong, I do sympathize with these people, and I’ll care for them without judging them for their actions… but I just don’t think it’s right from an economic standpoint to make the hospitals and ERs and physicians and taxpayers foot the bill for “preventable” (<–key word) illnesses).

  2. “I say let’s find out. Ban direct-to-consumer advertising by hospitals and doctors, and try instituting better tax incentives for providing charity care.”

    YESSS!!! I’ve written several essays on that premise. Also, I personally think that all the money pharma spends on TV ads should be redirected to researching NEW treatments/diseases (i.e. not just a variant on a competitor’s theme). In one essay, I proposed that a prestigious monetary award be developed (kinda like the Nobel Prize but on a smaller scale) that would be given annually to the pharmaceutical company or medical research team that developed the “best” new therapy that year. (“Best” being a complex scoring system determined by safety of treatment, “cure” rated higher than “manage symptoms,” additional points awarded for prevalence…and thus more potential worldwide benefit…, etc.) Yeah, it was an idealistic undergrad’s imaginings, and thus there are TONS of kinks to work out.

    But I absolutely, 100% support banning direct advertising and giving better tax incentives for charity care.

    I also support eliminating “wasteful” treatments and pushing for better access to preventative health care and giving incentives for healthy living (i.e. I’d rather give more money to someone, uninsured, with a costly illness that TAKES CARE of their body the best they can… eating right, not smoking/doing drugs/drinking excessive alcohol… than to a person that shoots up every night or smokes a pack a day or gets diabetes/CVD from their eating habits. I support their right to obtain pleasure at the expense of their body,…heck, even my dad would fit under that population description… and don’t get me wrong, I do sympathize with these people, and I’ll care for them without judging them for their actions… but I just don’t think it’s right from an economic standpoint to make the hospitals and ERs and physicians and taxpayers foot the bill for “preventable” (<–key word) illnesses).

  3. sorry…computer stutter. didn’t intend for that to post twice.

  4. Yes, yes, YES! Where can I sign the petition?

  5. Working in an area with very low socioeconomic status, I would love for some sort of break for charity care….

    I am an oncologist, so those ads that suggest/imply that cancer can be curable (when many cancers are not), really rub me the wrong way.

    I recently saw a gentleman with recurrent cancer. His family became quite upset when the doctor taking care of him suggested that it would be a “waste” to come see me. The reality is that it IS a waste — this poor man would not tolerate chemotherapy, and he no longer has the mental faculties to allow him to cooperate with certain tests, much less treatment. That may seem cruel, but that is a reality. Although the primary had been willing to suggest that it was a waste to come see me (causing significant anger from the family), no one had talked to them about the progression of the dementia. He was already having difficulties with swallowing. What about a feeding tube? When he develops an aspiration pneumonia, how aggressive were they going to be? In my opinion, this patient was appropriate for hospice because of his dementia. I think it would be wonderful if people viewed hospice as appropriate for more than JUST cancer (I know that it is, but in my community, it is rarely used for anything besides cancer).

    At some point, our society has to deal with the fact that people don’t live forever. We seem to be so fixated on longevity, that we fail to see that we trap people in a kind of nightmare existence that isn’t going to improve. There are times when I feel physically ill doing my job….inflicting medical “care” on people with no chance of survival.

    We spend so much money on the chance of a miracle. Unfortunately, when one is confronted with an individual patient, it is hard to make that declaration. However, there are times when the potential of a miracle really is not worth the investment, but in our topsy turvy world fixated on longevity at ALL COST doctors seem to be required to treat.

  6. In my area, we have a major turf battle going on between the state-funded university hospital and the state-funded county hospital: each one is luring docs from the other with big bucks, filing law suits against the other, upping the advertising budgets by 1000%. It’s insane!

  7. I am 100% in favor of banning direct-to-consumer advertising from doctors, hospitals, and drug companies! Because that’s one change that’s guaranteed to reduce wasteful medical spending.

  8. Since it turns out that direct corporate contributions to political campaigns are “free speech,” I suspect there would be no way to ban advertising by health care providers.

    One of the reasons the US doesn’t have the wonderful medical care **system**we ought have given the superb quality of medical care itself is for-profit medicine. Years ago, most hospitals were run by government entities, public authorities or charities. They more or less answered to the public. Now nearly all hospitals are run by for-profit chains that answer to stockholders. Years ago, not-for-profit Blue Cross/Blue Shield plans covered by far the majority of Americans who had health care insurance. Today even the Blues are for-profit, and hardly anyone but Medicare or Medicaid patients is covered by a not-for-profit plan.

    For-profit medicine means that every dollar that goes to patient care needs to contribute a component to investor ROI and high executive salaries as well as paying doctors, nurses, paramedics and all the other people who actually touch the patient.

    For-profit medicine means more expensive testing; someone has to pay for those state-of-the-art MRI machines. At the same time, it means less treatment, because things like heart transplants require a lot of expensive time from health care providers but only benefit a few people.

    Unfortunately, medicine has become so capital-intensive that I don’t think it can return to the not-for-profit model.

    Doctors and patients alike are being hurt by our current system. I wish I was smart enough to figure out how to fix it.

  9. […] More Wasted Money […]

  10. And while you’re about it, can you ban direct-to-consumer drug advertising? Just imagine how much money gets spent on those dopey ads with those couples in separate bathtubs!

  11. and how much money could be spent on care if hospitals quit giving money to press-ganey et al.

  12. No medical ads and no legal ads (“Do you have [insert vague symptom here]? We’ll sue someone for you!” or “Been hurt in an accident/playground fall/mean look from your 4th grade teacher?” ad nauseum), and no pharmaceutical ads either. My $.02.

  13. ya’ll don’t understand. The ads are not advertsement. They are patient education and hence very tax deductible. 😉

  14. RE: Brighid

    “Years ago, most hospitals were run by government entities, public authorities or charities. They more or less answered to the public. Now nearly all hospitals are run by for-profit chains that answer to stockholders.”

    17% of hospitals in the US are investor-owned, not “nearly all.” (http://www.aha.org/aha/resource-center/Statistics-and-Studies/fast-facts.html)

    “For-profit medicine means more expensive testing; someone has to pay for those state-of-the-art MRI machines.”

    A hospital’s status as for-profit or not does not void the need to cover operating expenses, including technology and capital investments. “Not-for-profit” doesn’t mean “Loses money.”

  15. non-profit hospitals must advertise to get the commercial (managed care)-paying patients. Without them we lose so much money because governmental payors don’t cover costs – for hosptiasl or physicians.

    The current reimbursement systems don’t even cover our costs, much less make money needed for capital investments in new technologies and facility upgrades that our docs demand.

    If we don’t the docs what they want, they move on to next hospital.

  16. As some one who works for a non-profit hospital in their marketing dept, I agree that it does seem a bit preposterous for a hospital to even have a marketing dept in the first place, but after working here, I realize it’s not as cut and dry as so many of you would love to believe.

    Whether you like it or not, medicine has turned into a money making industry. We can all bitch and moan about it, but thanks to our capitalist society, that’s where we’ve ended up. If hospitals don’t make money they close – it’s happening all around. So tell me what a community would like better, a hospital touting its laurels or an empty building where no one can receive care.

    Medi-cal, medi-care and most other insurance companies will nickel and dime hospitals over what they chose to re-imburse them for and what they don’t. You can wait for re-imbursement on a case for more than a year. How do we continue to run a hospital if we’re still waiting for payment or better yet, when no one pays because they don’t have insurance?

    The fact is, people are choosing everything for themselves these days. Thanks to the internet and social media, you can get opinions on just about everything and decide where it is you want to go for treatment – not just the one around the block. And some hospitals plainly put, give better treatment than others. If your husband or wife was having a heart attack and you had the choice of 2 hospitals equidistant from each other, but you knew that one hospital won an award for heart care excellence, which one would you choose?

    Hospitals have to attract patients. Hospitals have to care for their communities. Advertising is just one avenue to let patients know what options are out there for them. And if you really want to ban someone from advertising, why start with hospitals who are only there to fix the problem? Why not start with the banning the problem itself?

    Smoking, drinking, obesity… these 3 simple things can cut down by leaps and bounds the number of strokes, heart attacks, cancers, etc that we see in the hospital everyday. Ban beer ads or ban McDonald ads – take on the real problem first.

  17. From a presumably intelligent physician, I guess I’d expect a little more than black-or-white thinking. Like most things, there are shades of gray here.

    For example, if we market the need for age-related preventative tests, someone responds, and we catch early-stage cancer, pre-diabetes, or borderline high blood pressure, is that a waste of money?

  18. Be careful for what you wish for, as you might get it. In Accountable Healthcare Organizations (ACOs) of the future under Healthcare Reform:

    1. PCPs must be exclusive to one ACO; specialists can belong to many
    2. Patients are assigned to an ACO; hospitals are assigned to patient primarily by PCP affiliation

    So the hospitals will focus more on acquiring docs instead of advertising directly to patients. If neither the doctors, nor the hospitals can advertise to attract patients, unassigned patients will have to rely more on insurance companies, whom I trust even less!


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