Why should a hospital permit its salaried specialists to spend a needed half an hour to forty-five minutes with patients suffering form more complicated ailments when it can restrict the time spent to the ususal ten minutes, so that rather than screening the patient for what is needed the physicians must prescribe a series of expensive testing and imaging? The hostpial loses money under Mediaid for the doctor’s time and makes money through testing!
The whole economic system is nonsensical. Medicaid reimbursements are but a small fraction of what would be charged to insurance companies or individuals. Testing is very profitable. The hospital desires to make money, not to lose it.
Who is to blame for following financial incentives? Even when an insurance company owns the hospital, it will be subject to the same socially counterproductive fianncial incentives when it comes to Medicaid and certain Medicare patients.
We need to align the incentives of the payers with the providers in order to successfully revise our health care system and bring our costs and outcomes in line with the more successful systems in other economically advanced nations.
