The Economist points out a study that found an interesting but little commented-on aspect of the Affordable Care Act:
Hospitals in districts where a Republican congressman supported the Medicare Modernisation Act were five times more likely to receive a waiver than those in ones where a Republican lawmaker voted against. Those hospitals spent 25% more than they otherwise would have in the seven years after the law, according to the researchers. Between 2005 and 2010 the 29 hospitals that received the most lucrative waivers spent an average of $1.25bn more than if they had not received one.
Some of the windfall went on equipment and staff. The average hospital to benefit from a waiver increased its number of nurses by 16% per year from 2006 to 2010. But the splurge seems not to have improved care. No changes were registered as a result in the mortality rate for patients admitted to hospitals with a heart attack, or in the time taken to discharge those who survive one—two standard measures of quality.
Chief executives fared well, though. The average bump in bosses’ pay in the sample of hospitals benefiting most from the waiver was 81% over the same period, equating to a pay rise of about $428,000 per year above that received by bosses of similar hospitals with no waiver. Politicians benefited indirectly. Legislators with hospitals granted waivers in their district saw a 22% overall increase in campaign contributions after the act. Donations from individuals in the health industry in their state increased by 65%.
In other words in explaining the high cost of health care in the United States, your investigation should start and end with Congress. It didn’t start in 2013 or even in 2010. It began more than a half century ago when the Congress began using health care as a political lever.
Don’t expect the Congress to remedy the situation now or ever. More than anything else they want to keep their jobs.
