According to Alan A., the nurse generally handles three or four patients at a time. That would mean Sloan-Kettering is billing more than 1,200 an hour for that nurse. When I asked Paul Nelson, Sloan-Kettering’s director of financial planning, about the414-per-hour charge, he explained that 15% of these charges is meant to cover overhead and indirect expenses, 20% is meant to be profit that will cover discounts for Medicare or Medicaid patients, and 65% covers direct expenses. That would still leave the nurse’s time being valued at about 800 an hour (65% of1,200), again assuming that just three patients were billed for the same hour at $414 each. Pressed on that, Nelson conceded that the profit is higher and is meant to cover other hospital costs like research and capital equipment.
I don’t know any nurses who get paid US800 an hour. Hell, I don’t know any nurses who get paid even US50 an hour. An acquaintance works 12 hour shifts at a nursing home and at the end of the day gets paid about US$10 an hour by her own reckoning. She gets yelled at, bit on, pissed on. Her employer constantly threatens her with unemployment to obtain free labor. She doesn’t have any satisfaction about her job or herself at the end of the day.
I’ve gotten paid the same amount per hour washing dishes and I’ve gotten the satisfaction of hearing people say “these are the cleanest dishes I’ve ever seen at a restaurant.”
In Mexico we’ve got some price controls implemented so the most egregious overcharging doesn’t happen… but then again, most people would prefer spending more money than they can than to go to a state hospital managed by the IMSS, where mothers give birth on the bathroom floor and you can spend 12 hours sitting in the waiting room before a general practice doctor will even bother to tell you to go home.
I’m now wondering how long until the IMSS is dismembered and the pieces sold. Millions will instantly be unable to afford any kind of emergency healthcare and most types of outpatient care; the same thing that’s happened in the US will happen in Mexico. It will happen by design too.
You can go to the hospital, but you can never leave it behind. The sticker shock at the bills will prevent any kind of health recovery, not matter how many drugs they pump into you.
Then again, it’s by design. A hospital without consumers makes no profit.