Germs of Endearment

By Bill Maher

I think we've all known someone who's gone into the hospital and then there were "complications." There was a staph infection or they "developed pneumonia" or there was a "reaction to the medication" or there was a "sponge bath incident." And even if you don't know someone who's experienced these things, there are plenty of articles about hospital infections and other complications and it's always either stated outright or implied that many of these issues could be avoided if hospitals were more willing to adopt some protocols like the "safe surgery checklist." So what's up?  Why the foot dragging?

Well, it turns out hospitals profit more – way more – when patients have complications. As The Washington Post reported, "A surgical complication increases a procedure's average contribution margin by 330 percent for the privately insured and 190 percent for Medicare patients, according to a study published… in the Journal of the American Medical Association."

Think about it. If your surgery goes off without a hitch, you pay for it and head home in two or three days. If there's a "complication," you're in there for a few weeks – or what hospitals call "code ka-ching" – and you end up paying through the nose… if a staph infection hasn't already eaten it away.

More Washington Post: "When a surgical complication occurred, the profit margin jumped from $16,936 to $55,953. For Medicare patients, profits grew from $1,880 to $3,269."

The financial incentive for the hospital and your doctor is for your surgery to be over and suddenly, "Those stitches don't look good. I'm going to order some tests."

Shouldn't we incentivize sterile conditions and complication prevention by having insurance companies pay a slightly higher flat rate for each procedure and stick the hospitals with the cost of complication care?