A children's hospital in Calgary
Mea culpa. My only defense is that I’m not the only one.
When I/we/many of us take higher-cost hospitals to task for driving up health care spending, we tend to give Children’s Hospital Boston a pass, even though goodness knows it’s a big spender.
In fact, I just looked back at Attorney General Martha Coakley’s latest report on what drives health costs up here, and if higher spending were a race, Children’s would be a front-runner. Here’s a sample from the Coakley report — note Children’s on the far, far right:
So why don’t we see cost-minded people beating on Children’s the way they do on, say, Partners HealthCare? Is Children’s a sacred cow? When I look into my own heart, I definitely find hesitation that might best be translated as “No amount of money is too great if my own child is sick.”
But that emotional response doesn’t mean Children’s spending should be beyond scrutiny — which is why I’m thrilled to see a major Kaiser Health news series under way on the business of children’s hospitals, focused in particular on a fancy new project in Orlando, the Nemours Children’s Hospital. It’s here, it stems from a year-long investigation, and its thesis goes like this:
The battle over Nemours reflects the transformation of children’s hospitals from small, struggling charities to huge, often profitable businesses. From their humble origins more than a century ago, many of the nation’s biggest and best known children’s hospitals today are health care juggernauts with sprawling medical centers and suburban satellites, extensive real estate holdings and thousands of well-paid employees and millionaire CEOs.
The billions of dollars flowing through children’s hospitals every year pay for care for tens of thousands of kids, many of them extremely sick or suffering from chronic conditions requiring a lifetime of treatment. Hospital officials say costs are high because the care is complicated and the technology expensive. In addition, the hospitals help fund research into the causes and treatment of diseases.
But the surge in spending is also helping to fuel a multibillion-dollar building boom as hospitals add towers and beds. That in turn is spurring more spending on staff and technology, even as Washington, the states and employers grapple with budget-busting increases in health care spending. While children’s hospitals represent a small slice of the nation’s health care bill, they offer a case study of the expansive ambitions of hospital leaders and the faltering efforts of government to control spiraling costs.
And another key point: Continue reading