For centuries, hospitals have served as a
cornerstone to the U.S. health care system. During various touch points in
life, Americans connect with a hospital during their most intimate and
extraordinary circumstances.
Most
Americans are born in hospitals. Hospitals provide care after serious injuries
and during episodes of severe sickness or disease. Hospitals are predominately
where our loved ones go to die. Across the nation, hospitals have become
embedded into the sacred fabric of communities.
According
to the American Hospital Association, in 2011 approximately 5,754 registered
hospitals existed in the U.S., housing 942,000 hospital beds along with
36,915,331 admissions. More than 1 in 10 Americans were admitted to a hospital
last year.
Hospitals
make a substantial imprint on local economies. In many communities, hospitals
represent one of the largest employers and economic drivers. Of the total
annual American health care dollars spent, hospitals are responsible for more
than $750 billion.
Despite
a history of strength and stature in America, the hospital institution is in
the midst of massive and disruptive change. Such change will be so
transformational that by 2020 one in three hospitals will close or reorganize
into an entirely different type of health care service provider. Several
significant forces and factors are driving this inevitable and historical
shift.
First,
America must bring down its crippling health care costs. The average American
worker costs their employer $12,000 annually for health care benefits and this
figure is increasing more than 10 percent every year. U.S. businesses cannot
compete in a globally competitive market place at this level of spending.
Federal and state budgets are getting crushed by the costs of health care
entitlement programs, such as Medicare and Medicaid. Given this cost problem,
hospitals are vulnerable as they are generally regarded as the most expensive
part of the delivery system for health care in America.
Second,
statistically speaking hospitals are just about the most dangerous places to be
in the United States. Three times as many people die every year due to medical
errors in hospitals as die on our highways — 100,000 deaths compared to 34,000.
The Journal of the American Medical Association reports that nearly 100,000
people die annually in hospitals from medical errors. Of this group, 80,000 die
from hospital acquired infections, many of which can be prevented. Given the
above number of admissions that means that 1 out of every 370 people admitted
to a hospital dies due to medical errors. So hospitals are very dangerous
places.
It
would take about 200 747 airplanes to crash annually to equal 100,000
preventable deaths. Imagine the American outcry if one 747 crashed every day
for 200 consecutive days in the U.S. The airlines would stand before the nation
and the world in disgrace. Currently in our non-transparent health care
delivery system, Americans have no way of knowing which hospitals are the most
dangerous. We simply take uninformed chances with our lives at stake.
Third,
hospital customer care is abysmal. Recent studies reveal that the average wait
time in American hospital emergency rooms is approximately 4 hours. Name one
other business where Americans would tolerate this low level of value and
service.
Fourth,
health care reform will make connectivity, electronic medical records, and
transparency commonplace in health care. This means that in several years, and
certainly before 2020, any American considering a hospital stay will simply go
on-line to compare hospitals relative to infection rates, degrees of surgical
success, and many other metrics. Isn’t this what we do in America, comparison
shop? Our health is our greatest and most important asset. Would we not want to
compare performance relative to any health and medical care the way we compare
roofers or carpet installers? Inevitably when we are able to do this, hospitals
will be driven by quality, service, and cost — all of which will be necessary
to compete.
What
hospitals are about to enter is the place Americans, particularly conservative
Americans cherish: the open competitive market. We know what happens in this
environment. There are winners and losers.
A third
of hospitals now in existence in the United States will not cross the 2020
finish line as winners.
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