Too much health care is bad on many counts

Two recent articles highlight the massive inefficiencies in the US health care system. In Philadelphia, five hospitals now have heart transplant programs, even though there are only enough patients for two. The result? Hospitals will not perform enough to gain the experience needed to improve safety and efficiency while lowering variable costs.
A few hundred miles away, a (reg req)group of cardiologists in Elyria Ohio have evidently decided that their Medicare patients need angioplasties four times more frequently than the national average. I wonder if it’s the fried dough at the Elyria fair?

Whatever the cause, the net impact on the bottom line of the North Ohio Heart Center (NOHC) amounts to over $2.7 million a year, or just under $100,000 per year per physician. And their local hospital benefits as well, earning $11,000 per procedure for a total of $37 million annually.
And it’s not just the money. According to the NYTimes article, the 31 docs in the NOHC practice not only perform angioplasties on patients at the lower end of the risk spectrum, they also do them when other docs would recommend a bypass. Unfortunately, NOHC docs aren’t able to perform bypasses, as they are not surgeons. And because almost all the cardiologists in and around Elyria are part of NOHC, patients unwilling to travel have little choice in their care.
Let’s see. Docs that are financially incented to perform angioplasties dominate a local market, increasing the local hospital’s revenues while also raising local employers’ health care costs and Medicare taxes.
Over in Philly, the increasingly competitive market for heart care has hospitals scrambling to provide the widest possible range of care, up to and including transplants. This despite the consensus that the market can’t support more than two transplant centers.
I’m betting the heart transplant rate in Philadelphia goes up substantially this year.
Any takers?
and thanks to FierceHealthcare for the Phila tip!