Is there something fundamentally wrong with US hospitals?

First, a report comes out that US hospital prices are arbitrary and confoundingly high, then it’s discovered VA hospitals have confoundingly high wait times. In regards to prices, hospitals tend to play a shell-game and stick it to the working poor and lower middle class much like the mortgage industry did not long ago. That’s unethical of hospitals. Not only did the VA hospitals fail to meet demand, they lied about it and covered it up. Also unethical and probably illegal.

I feel it’s not off the mark to say that we need to take a close look at how hospitals are run, managed, financed, and how they pay salaries and bonuses to employees and administrators, as something seems to have gone awry in the mission hospitals have to provide healthcare to patients in an ethical manner.

Where are these hospital’s ethics and sense of purpose? Are they only concerned about money these days? Are they simply lazy? Why do they feel they aren’t accountable?

Maybe hospitals and hospital systems need to be decentralized? The idea of combining hospitals into hospital groups was to take advantage of economies of scale to lower costs. That didn’t happen. Maybe instead of having a handful of high-rise hospitals in a city or region, there should be dozens of much smaller hospitals in the same area that would be forced to compete with one another? Maybe a smaller scale would force these hospitals to be more patient-centric and to be more concerned with quality of care rather than quantity? You know, operating more in a boutique manner than in a factory manner? Perhaps a Walmart, box-store concept to hospital care simply doesn’t work? Perhaps the doctor-patient relationship needs to occur in a more intimate setting? It would seem that hospital epidemics of MERS, staph, and pneumonia could be reduced with more and smaller hospitals in a given area. The consolidated, centralized, high-rise concept did not work for public housing, perhaps it simply cannot work for hospitals as well?

So then have hospitals hit the too-big-to-fail wall?? You know that wall that financial institutions hit when they became so big and powerful and their staff so well-paid that they totally lost their focus of their position in society and in their core mission of what they provided to their clients? Maybe there’s some kind of sociological law about the size of an institution: that at a certain point an institution becomes so large that it loses its way and becomes disconnected, that staff members get stuck in a small-cog-in-a-large-machine syndrome where everyone loses sight of the mission and assumes somebody else has their eye on and is responsible for the big picture?