Inactive Tutor answered • 07/09/19
Speaking from the perspective of a medical student and a healthcare administration expert, here's an outline of what's likely to happen:
The outcome of hospitals is primarily dependent on the success or failure of healthcare reform. If we should do away with private insurance altogether and all at once, physicians and hospitals will suffer and likely become bankrupt from the lack of larger revenue (remember, private insurance pays a lot more than Medicaid and Medicare do). If the transition is made to allow public insurance plans (Medicaid and Medicare) to pay larger sums to the hospitals and physicians while also providing a low-cost or no-cost option for the general population, then that will hold hospitals together and keep people actually wanting to be in healthcare. The issue is that the money has to come from somewhere, insurance companies won't shell out at equal values what the consumers put in, they have to get paid too. Thus, if there is a move toward Medicaid for all and a national healthcare coverage only path, then the dollars to fund this endeavor and cut out the insurance company price-setting completely, the money is going to have to come from the government. Who funds the government? Well, we do and we do it through tax dollars. Countries like Norway and Sweden have some of the most full-coverage healthcare-for-all plans and their taxes are sky high, I mean, we would freak if our taxes were that high. But that's just it, they're extremely happy to pay those taxes because people are a little healthier and can do more with chronic illnesses, they're actually costing the country less money by being less sick.
The average cost of a diabetic or a person with coronary artery disease in this country is pretty astronomical over a lifetime and most of it is due to non-compliance, meaning they don't or can't take their medication as prescribed to them. Notice that the cost of insulin is also rising in this country? Yep, that's also contributing to healthcare strain. Put the rising costs in medications together with inconsistent ability or fear to see a doctor or receive a medication due to healthcare coverage plus the stress of being sick and needing to miss work because you are sick? You get a recipe for a pretty bad patient - doctor - healthcare institution outcome. So while we're paying more and more for our care, we keep getting sicker. This isn't because our doctors are bad or our hospitals are crooked, the system itself is failing.
The recent closure of Hahnemann University Hospital in Philadelphia and the displacement of hundreds of doctors, resident physicians, fellows, and medical students is a direct result of everything starting to implode around the cost of healthcare. All of those medical students, residents, and fellows are also in a momentous amount of student debt, so tack that on to the growing strain behind the healthcare system.
So, the future of the "hospital" is simple: cap costs for life-saving or life-sustaining medications for chronic diseases, increase taxes especially for the wealthy, cover more people at lower costs, increase or at least maintain RVU's** and reimbursements for physicians, make medical school/nursing school less costly to attend, or this system will implode in a matter of decades.
I love what I do, I wouldn't do anything else, but I'd give anything to see our system better itself at the level of the US Government. There are a lot of theories out there and there is definitely more to the argument than even I can break down at the moment, but this is the basic premise of why current healthcare professionals in training are so incredibly frustrated.
**NOTE: Look up what an RVU is as it is extremely important to how hospitals and physicians make their money. I'd explain it here, but I think these guys do it better: https://www.nhpf.org/library/the-basics/Basics_RVUs_01-12-15.pdf
