Dr. Martin Hash Podcast

Almost all medical costs are fixed. A hospital doesn't get any cheaper by not having patients: the equipment & the medical staff have to be there whether there's one patient or the Waiting room is full. Think of the whole hospital as one cost & more people using it wouldn't make much difference to prices. Also, different costs assigned to different procedures are purely artificial: fixing a broken arm takes no more resources than “sniffles;” and an MRI of a head injury costs no more than treating a diabetic. Primary doctors are multi-disciplinary & multi-tasking, and if a specialist is needed, hospitals have escalation procedures for that; more patients cause little additional burden to the existing hospital infrastructure, and the drugs prescribed are overwhelmingly cheap generics. The ER works on the principle of triage & treat, in & out, every possibility covered as efficiently as possible.

Most large cities have at least one hospital, usually in a poor area, with “Clinic” that utilizes this Fixed Cost idea: Monday/Wednesday is OB/Gyn; Tuesday is GP/Peds; and Thurs/Fri is procedure follow-ups including outpatient surgery, oncology, podiatry, etc. Plus, people know where their hospital is, and feel comfortable that all the other people waiting are just like them. The anonymity is soothing because the reason for their visit does not make them the center of attention, and they aren't reluctant to simply do what everyone else is doing,which is waiting, and if someone truly injured comes in, everybody accepts that that person goes first. Herd mentality has a calming affect, and frankly, it's cheaper too.