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Health care is run more professionally than tech and is long term sustainable without so much ageism. That means the labor costs are a little bit higher, and the capex is out of control. If you go to urgent care and there's no waiting x-ray tech or radiologist, you will wait in line until the local guy clears the backlog, which might take awhile, but you're not at urgent care unless its not a medical emergency, patient in stable condition, etc. Stable condition does not mean you're perfectly thrilled and happy with your health, it means you're not in the dying process. At the ER they're paying on call for zillions of people and if you need an x-ray and they're busy, then as fast as a radiologist can drive in, one will magically appear. This is very expensive, my buddies obgyn wife got $600 per day just to carry a phone and it takes a heck of a lot more than one OBGYN to do everything an ER could possibly need, and the patients as a group will amortize that cost. My wife's friend's husband is an anesthesiologist and they get closer to $2K per day on call. It adds up and you get maybe two of each of the village people and by the time you're done, running a real hospital means you're burning $100K per day on people who aren't working that day... The patients will pay, of course. A side dish is the capex, merely replacing a CT scanner machine every 8 or so years will cost about $500/day. Not to run it, not to buy supplies, not to power it, not the real estate cost per square, just buying a new machine every 8 years is $500/day and thats a mid-range cost, obviously MRI are more expensive or ultrasound imaging is a bit less. Regardless if you need it or not, because there's like 200 other machines also very expensive and someone has to pay for all that. Then there's the medication expiration scam, can't ever run out of Advil but when it expires annually you buy more. Departments get remodeled or newly built every decade or so and the going rate seems to be around $10M for a new or remodeled department every decade or two. I would guess its another $100K per day to stock an empty building with the capital goods, even if you barred the doors. The patients will pay, of course. In tech terms a good analogy is you can get a password reset by the helpdesk at 2am for not too much money, but if you expect a level of service such that you can call at 2am on Christmas morning with a wishlist bug and a new bug free safety-of-human-life qualified release will be shipped immediately while you're on the phone, this is possible only because there are people that really like money... lots and lots and lots of money. Another way to look at it, is its nice to visit an ER where they never ever say "yeah we could in theory save your life, but we had to save money so no XYZ machine or medication or treatment, too bad" but however nice it is to visit, you're not gonna like the bill. The best medical care money can buy is going to be expensive. |