The Maine Idea: Hospitals are also part of the health care dilemma
I used to think the gold standard for American health care reform would be a "universal" or "single-payer" system similar to
For the
It would also require a much tighter rein on the joint federal-state Medicaid programs, which Republican governors have outrageously abused to deny fully-funded care to an expanded group of poor people while imposing onerous work requirements.
That would still leave some Americans uninsured. Filling the gap might require more generous subsidies, and a return of the penalty for not buying insurance that a
But it could be done.
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Yet I've begun to wonder whether even this would be enough to solve the problem of sky-high costs.
After all, other countries, including
What makes the
We often think the big distinction is between for-profit and nonprofit hospitals, and for-profits do try to shed unprofitable patients and avoid unprofitable procedures.
Yet nonprofits are hardly blameless. Following the ACA debate, one remarkable investigative report identified a nonprofit in
There was seemingly nothing unusual about the hospital, and confronted with the facts, the administrator at first denied it could be, then finally admitted the reporter was correct.
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Another report's depressing conclusion was that the reason our health care costs are so high is they're already high and keep going up every year.
That's because our programs, with few exceptions, bill solely for medical procedures and not for keeping Americans well — what one might naively presume to be the goal of having a health care system.
Just ask nurses at Maine Med in
In
Small rural hospitals were once championed in
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In 2014, it sold out to
Central Maine Med in
The only successful community merger came in
We've ended up with only two large hospital chains;
There's one truly public hospital in
In the end, we must finish the project begun by the ACA to achieve universal coverage.
Yet we'll never reduce costs satisfactorily until we start applying scrutiny — a lot of scrutiny — to the way hospitals operate.
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