Health care costs increase for several reasons: inflation, research and development, increased salaries for doctors and nurses, the need for insurance companies to appease investors, charitable care, and location-based factors. Now we can add questionable executive management decisions.
In NY, Bronx-Lebanon Hospital found questionable ways to boost revenue to pay executives fat salaries, bonuses, and perks. This taxpayer-supported institution — whose construction project is in investigators’ crosshairs over alleged links to mob kickbacks — pushed moneymaking surgeries such as hip and knee replacements.
Marketing a hospital to draw patients requiring high-return surgeries is allowable. However, Bronx-Lebanon Hospital specifically hired a doctor with a record of alleged poor outcomes to help boost revenue. The hospital lavishes its chief of orthopedics, Dr. Ira Kirschenbaum, with hundreds-of-thousands-of-dollars in bonuses despite four deaths and numerous preventable injuries that occurred after he arrived in 2008.
Dr. Kirschenbaum received a $314,210 bonus in 2014 and a $180,940 bonus in 2015, according to Bronx-Lebanon’s tax filings. The bonuses were in addition to his $851,000 salary.
Several hospital employees notified the state medical disciplinary panel to complain about patients recently injured under Dr. Kirschenbaum’s care. The NY Post reported that Dr. Kirschenbaum denied allegations of negligence and said the OPMC cleared him in earlier cases.
High volume practices and surgeons who practice for many decades will have adverse outcomes that are not the result of negligence. Concern about Dr. Kirschenbaum arises from the way he was hired. Hospital CEO Miguel Fuentes hired Dr. Kirschenbaum as a division chief without consulting Dr. John Cosgrove, who was then chief of surgery and would have overseen Kirschenbaum. Dr. Cosgrove did not have a chance to vet Dr. Kirschenbaum.
In other words, the hospital’s CEO made a business decision to hire Dr. Kirschenbaum without investigating his safety. Preventable medical errors always increase health care costs. The increases come from trying to fix the problems caused by the doctor’s negligence. Hospitals and doctors have ways to code the additional care to make it appear as a normal complication of the patient’s condition. These costs are then passed on to taxpayers through Medicare and Medicaid, and other people with health insurance through increased premiums. The costs increase further when hospitals create an incentive system to entice doctors to schedule additional, and possibly unnecessary, clinic visits, or perform surgeries with questionable indications. These are the real causes of increased health care costs, not malpractice lawsuits.
Hospital executives often enjoy hefty salaries and bonuses, as do doctors. Just look at the nations highest salaries (9 out of the top 10 are in health care) or jobs of the nation’s top 1% (health care providers make up the second largest portion). There is nothing wrong with making a lot of money, but we should think twice before we believe hospitals and doctors are struggling because of malpractice lawsuits.