10 thoughts on “More on the Hospital Building Boom”

1. Grrrr! My favorite topic again! Who’s Drew? “Evolution of patient care?” Patient care hasn’t evolved, it’s disappeared. I don’t know about Iowa but here in Houston the many high-profile construction projects underway in the Medical Center have nothing to do with patient care. MD Anderson built a multi million dollar bridge and a new tower for their faculty. Memorial Hermann is building parking lots and office space and data centers and what will be the tallest building in the Med Center. Woo-hoo I want to go there when I’m sick and check out the view from that bridge with my IV pole in tow. Oh wait, I can’t afford to park in the Med Center, much less afford their medical “care.” Research facilites, only one that I know of at Baylor is to actually accomodate actual patients, but not improve their care or provide access to care for people that need it. I’d venture to guess what’s happening here is happening across the country on a smaller scale. Evolution of patient care, indeed. They’re not fooling me and I doubt they’re fooling anybody but they sure spend a lot of money on advertising to let the world know who wonderful they are. I’m mad.

2. On the “flip-side” of this, last year, Berks County, Pennsylvania received a new state-of-the art hospital after 133 years. It’s not every day that a community witnesses the passing of a 133-year-old institution. It was the end of an era, but the beginning of a new one.
   It was a combined 430,000 square-foot medical center and offices, and easy-to-navigate campus, with 175 private rooms – 212 total rooms – high-tech operating suites and emergency care area, Heart Institute, Cancer Center, orthopedic joint implant center and a Maternity Care unit, all under one roof.
   The creation of this state-of-the-art health campus ensured that the entire community receive care for patients in a 21st Century platform in which to practice innovative and quality healtcare that is so critical to a healthy community. Witnessing a recent four-day stay for my very senior mother, it was a blessing.

3. In our city, three of the largest four building projects over the past 5 years where hospital expansions. No additional beds or improved nurse patient ratios were created. I do know that because of the funds spent on construction, the hospitals remained within their profit limits and can remain tax free facilities. I guess to avoid spending on city and state taxes, they chose to spend excess profits on new digs.

4. In Portland, Oregon, the cranes are over almost every hospital with huge additions or new buildings. The finishes rival five-star hotels — not cheap. Has better health care resulted? Have more people been given access. Absolutely not, and their increased mortgages and overhead most certainly aren’t going to make this more likely.

5. I had an epiphany driving home from work. Maybe you guys already figured this out and I’m just late to the party, wouldn’t be the first time.
   So what they’re building a bridge, healthcare is just as money-driven to me as it is to them. All of us, we’re all guilty. Money in my pocket is generated revenue, reformers put cost at the top of their list. What makes them wrong and me right? I diligently monitored costs when my husband was hospitalized because I knew it was costing somebody somewhere a fortune. I am a hypocrite.
   What makes “them” wrong and me “right” is they’re generating their revenue at the expense of human life and the good of all society. That’s really it. Everything is money driven, everything. I enrolled my daughter in school yesterday, was excited for her and all that is in front of her (10th grade). This girl has herself on target to graduate in 11th grade and mapped her plan out since 8th grade, unbeknowst to me (she is just like her mother.) Anyway, a lot of the classes had dollar signs next to them, additional fees (my taxes aren’t enough?) then the counselor gave me a buzz kill when she announced this is the last year of this type of schedule, etc because it’s cheaper to do it differently.
   Everything is money driven for all of us. Now that I’ve swallowed that bitter pill I see a much clearer road to fixing healthcare. For starters I don’t agree private health insurance companies need to be sustained. This goes back to an older post, but I say bring on the axe. Uncle Sam will need people to adminster healthcare, they will have cush government jobs instead of insurance company jobs. Some companies will go extinct, which is the natural evolution of society. Others will diversify and thrive, consumers may find themselves on the receiving end of cutthroat competition for all kinds of insurance. Do you know you can now buy “rain out” insurance, in case you plan an event and it gets rained out? We’ll see all sorts of “new” things available to insure.
   Hmmmmm….

6. Now the “flip-side” of my good hospital exerience in my community.
   The “other” non-profit hospital in the community spends all its money making it “bigger” but not “better.” It recently spent millions of dollars on a new comprehensive cancer center and regional heart center building.
   Having beautiful surroundings does nothing to camouflage botched medical care. The expansion was more splinter, scatter and fragment, rather than incorporate, consolidate and upgrade.
   It’s own director of hospital facilities said about the expansion, “you want to come into a place that makes you feel good even though you may not be able to pinpoint exactly why.” I couldn’t have said it better.
   Then they established a Trauma Center, even when they can’t “staff” the ordinary ER they have now. One orthopedic surgeon there told me, “the elaphant has gotten too big!” So the orthopeds built their own surgi-center. Oh, the shame!

7. Gregory, you must live in Houston.
   This is pulled right from the press release from Memorial Hermann Hospital regarding their 90+ million dollar vascular institute.
   “The $92 million facility will house 147
   patient rooms and six cardiac catheterization and electrophysiology
   labs with room to expand. Its six operating rooms will include two
   endovascular suites that enable minimally invasive and open procedures
   in the same room.”
   Let’s see, if I knew how much those procedures cost we could easily calculate how many they need to do before the place is paid for. What is that? $625K or so in revenue per bed before the mortgage is paid? Shouldn’t take long.

8. I wonder how MD Anderson is going to sell that bridge.

9. Lisa, not even close, but I do understand it could sound like a press release from any of the new hospitals being built across the nation.
   The replacement of 133-year-old St. Joseph’s Hospital in Berks County, Pennsylvania was an epiphany of good health care for our community. Well planned and executed. A blessing.
   Can’t say the same for Reading Hospital, the other health care institution. Like the orthoped said, “the elephant has gotten too big,” but it has an albatross circling overhead.

10. Thank you all for your comments.
    Lisa– I just stumbled onto Drew’s website. It’s well-researched, and I know some of you are very interested in this topic.
    You are right: in this country, everything is “money-driven.” But this really isn’t the case all over the world.
    For example, in Italy, life seems to a high degree, food-driven. Life revolves around the two main meals; shops close for the two-hour lunch; much time is spent on preparation, picking the best produce, etc. (Shop-keepers don’t mind that they will lose busienss when they close–even in Rome, where most of the shoppers are tourists adn not accustomed to the mid-day closings.)
    Romantic love, of course, is also important. As is family, children, women. ..
    Of course Italians also are interested in money, but it isn’t the dominant leit-motif the way it is here (particularly in places like N.Y.)
    Italians just aren’t interested in working that hard in pursuit of profit
    .
    After all, they built an empire. Been there, done that.
    Your daughter sounds great.
    Gregory– It does sound like the hospital that cared for your mother was needed.. After 133 years, it is time for some construction!
    At the same time, your description of the other
    hospital expansion you have witnessed sounds more typical:
    “The expansion was more splinter, scatter and fragment, rather than incorporate, consolidate and upgrade.
    “It’s own director of hospital facilities said about the expansion, “you want to come into a place that makes you feel good even though you may not be able to pinpoint exactly why.” I couldn’t have said it better.”
    “Then they established a Trauma Center, even when they can’t “staff” the ordinary ER they have now.”
    (This Nails It.)
    ” One orthopedic surgeon there told me, “the elaphant has gotten too big!”
    Peter R– You wrote: “hospital expansions. No additional beds or improved nurse patient ratios were created. I do know that because of the funds spent on construction, the hospitals remained within their profit limits and can remain tax free facilities. I guess to avoid spending on city and state taxes, they chose to spend excess profits on new digs.”
    I’m afraid that’s exactly the case. Hospitals should be plowing surpluses into electronic medical records that would help avoid errors, better nurse/patient ratios, palliative care teams, staffing ERs . . . but instead too many hospitals focus on the cosmetics.
    Biil– You raise the right questions: “The finishes rival five-star hotels — not cheap. Has better health care resulted? Have more people been given access. Absolutely not, and their increased mortgages and overhead most certainly aren’t going to make this more likely .”
    And as Lisa points out, these hospitals will be paying off this debt for years–raising the cost of care, while limiting access to those who can pay.
    There are some enormous egos behind these building projects–hospital executives and boards who see themselves as “master builders” and have completely forgotten about their “mission”–to serve the community.

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