Why Medical Care in Hospitals is so Expensive in the US

That really means very little to me. The fact that they charge $16,000+ to deliver a baby in the first place is the problem. And let's face it, on top of that, they probably get another $200 in parking fees from people coming to see the baby/mom, another $300 from the gift shop, another $500 from the cafeteria, etc.

Then, in three months, the insurance company will reject part of the bill and they will recalculate it and forward it on at a higher rate to the patient, as they always do.

The reason everything is so expensive, of course, is that a hospital used to be a singular organism--even in the US just 25 years ago. But now it's like a fucking Portuguese Man-O-War.

See, it goes like this:

• First there's the REIT or Real Estate Company that owns the actual hospital building and land it sits on.

• Then there's the Custodial company that manages the building and keeps it clean.

• Then there's the Landscaping company that manages the grounds. - Then there's the Parking company that manages the parking lot / garage.

• Then there's the Housekeeping company that manages all the linens and sanitation stuff that is not part of the building.

• Then there is the Catering company that manages the cafeteria.

• Then there is the Dunkin Donuts franchisee that owns the coffee shop.

• Then there is the Hallmark franchisee that owns the gift shop.

• Then there's the Pharmaceutical company that runs the on-site pharmacy and hires the pharmacist.

• Then there's the Pharmaceutical procurement and delivery company, which is actually separate and way more expensive than you'd think.

• Then there's also a separate Medical Goods Procurement and delivery company that might bring blood and organs and other materials necessary along with parts for machines or just regular old IV bags, etc.

• Then there's at least one separate Ambulance company.

• Then there's the Nursing Staffing Company (there may be two or more of these) that hires the nurses and purchases the medical equipment to provide the care.

• Then there's the Security company that hires the guard out front and installs cameras and creates logs and routes to protect the drugs etc

• Then there's the Temporary Staffing Agency that provides daily personnel support so that everyone else on this list can run as lean as possible.

• Then there's the Insurance Companies, who will have onsite staff to protect their interests who must be paid.

• Then there's the Hospital Network that negotiates against the insurance companies and functions as the marketing arm of the hospital.

• Then there's the Medical Billings, Coding and Records company. They probably carry whatever in-house IT staff there is, but they will only help these people, they are not typically supposed to support the nurses, for example.

• Then there's the Rehabilitation Company who hires the physical therapists and others who are there to help people recover.

• Then there's the Laboratory and Radiology work, which often can also be outsourced to separate companies.

• Then there are the Doctors, who are each usually acting and billing as independent for-profit corporations in-and-of-themselves.

• Finally, there's the Hospital Administration, whose job it now is to manage this big fucking mess to try to make the whole thing work together as best they can.

Every single one of these steps comes complete with its own separate shareholders and its own separate CEOs and other C-officers and their own separate branding and marketing and HR office and hiring practices and payroll systems with its own separate boards of directors and Vice Presidents and everyone else in a corporate tower downtown somewhere who also have to be paid and supported.

It wasn't terribly long ago that a city hospital downtown, or a non-profit religious hospital might have offered full services with all of these functions integrated under one roof with not a single shareholder or CEO earning a penny. These still were not the only or most common types of hospitals 25, 30 years ago, but they were way more common than today.

Now hospitals operate like shopping malls, and it's one big pile of business leaches jammed into a building that tries desperately to maintain the façade that it is a single functioning entity that exists to serve sick people...when in fact, it's nothing of the sort. It's actually a colony of dozens of for-profit companies each attempting to maximize the money they can extract from patients and their visitors for providing the most narrow of services possible. This has the bonus effect of confusing the living hell out of liability claims too...

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