The Nation's Pulse/Bedpan Hospitality (II)
Haag, Ernest van den
BEDPAN HOSPITALITY (II) by Ernest van den Haag Recently fate offered me another unsought opportunity to serve as your involuntary hospital reporter.* As before, I found the medical services in the...
...This is largely caused by government regulations and can be reduced only by simplifying them...
...You must be kidding...
...He was dying, and a friend of his wife (from whom he was separated) came to see him every day, against his wishes, to badger him about his will...
...They are also quite cheap...
...This expense should be borne by the community at large, but is not...
...Three meals a day are brought in and removed...
...The patient might be so comfortable he might never want to leave...
...Procedures apt to prevent sleep, although ordered as a daily routine for me, were always performed at night...
...4) Two hours later a woman appeared to clean the wash basin and the bathroom shelf...
...Hospital administrators have not yet discovered this development...
...Rooms, underequipped for comfort, are medically overequipped, (a) Every bed has a costly electrical motor which permits it to be raised and lowered in segments...
...Meanwhile it is horrendous and costly...
...Although the menu choices are limited, you can (at extra expense) order a steak...
...Less fun but much cheaper, (b) Every room has oxygen outlets...
...Not all of this is unavoidable...
...But you must eat it at the times decided by the management, or skip it, and, whichever way you order it, it comes overcooked...
...Hospital administrators act as prison wardens do, only more so...
...To the eccentric ways of making up a room one must add other routine matters to realize that a patient cannot count on much undisturbed rest in a hospital...
...Whereas the professional staff barely is adequate in numbers and is far from overpaid, the nonprofessional staff is overpaid (I think there are too many of them, too...
...And what does trivial comfort matter if the hospital is dedicated to health and firmly convinced that comfort and cure are inconsistent...
...How do I know...
...On parting each one left the door open...
...4) Medical care has become expensive because of the high and costly technology available to physicians, which has immensely improved care...
...He is treated accordingly...
...One is given no chance to buy new ones...
...Yet the hospital must make ends meet somehow...
...he has too much to lose, namely the care on which his life may depend...
...He could not lock his door and was practically and legally unable to throw out anyone the hospital let in...
...In the past doctors feared to treat the poor in the overcrowded and unsanitary hovels in which they lived...
...They are paid more than is needed to attract them...
...This is one reason why they are so high...
...They continue to treat everybody patronizingly and punitively...
...He asked me to prevent these visits which greatly upset him...
...He gingerly caressed parts of the floor for about two minutes...
...The lamp over my bed was designed and placed with diabolical cleverness so as to make reading almost impossible...
...Hospitals routinely do...
...But hospitals do not believe that a patient has any right to privacy...
...Granting that modern medicine with all its apparatus is costly, the size of the bill still remains a puzzle...
...Years ago a man with whom I was slightly acquainted called me from a hospital...
...I spoke with the head nurse and the resident...
...The following separate operations were performed in my room every day: (1) An elderly gentleman came in around 9 a.m...
...When the bed-bound patient rings a bell (actually a light goes on at the nursing station), he must wait from five to twenty minutes for an electronic voice to inquire about "the problem...
...I can see no reason why private rooms, as well-furnished as hotel rooms, should not be the rule in hospitals for all paying customers...
...Too frivolous...
...Magazines, books...
...Did some demented administrator read too much about specialization in his college days...
...But why do hotels manage to resist the unions and hospitals do not...
...Simple, isn't it...
...Is it really impossible to bring in next day's menu with the meal and pick it up with the dishes...
...Often the lelay does not matter, but in an emergency it might be costly...
...That you happen to be hospitalized and are insured, or able to pay, is no reason to stick you, rather than the community, with the cost for all those who are not...
...Since there are too few of them, routine procedures tend to be uncomfortably delayed, while they are busy dealing with emergencies, or in the operating room...
...They must be guilty of some sin to have been sentenced to sickness and hospitalization...
...unlike the prisoner he cannot rebel...
...If lucky, they were admitted to hospitals and treated there for the sake of charity...
...But hospital managers get heart attacks at the mere mention of such a possibility...
...Unless the patient regains an interest in minimizing costs, hospitalization will become ever more expensive—and, in the nature of things, ever more inhos pitable...
...I could rent a TV set—which in any hotel comes with the room...
...Ernest van den Haag is the John M. Olin Professor of Jurisprudence and Public Policy at Fordham University...
...A vase for flowers is unobtainable...
...1) Paperwork...
...A prisoner can refuse to see visitors...
...Hospitals feel that the patient is theirs to dispose of—for correctional purposes, of course...
...They can be clamped to the wall, and moved in any direction, illuminating anything...
...Other hospitals have them...
...My room was furnished about as well as a prison cell...
...But only a small proportion of patients need them, (c) There is an intercom with loud speaker in every room...
...Modern medicine, however, depends on an extensive apparatus available only in hospitals which, therefore, must be used by rich (or insured) and poor alike...
...Hospital rooms must be unlocked for the same reason that prison cells must be locked: to control inmates...
...Any hotel has a laundry service for guests...
...No hospital does...
...The knowledge that, whatever happens, there will be a delay, is not reassuring...
...3) Hospitals take care of many people who cannot pay and are not insured...
...5) The costs of hospitalization are paid largely by third parties now, in surance companies and taxpayers (via Medicare or Medicaid...
...So, hospitals shift the cost to paying patients and to their insurance carriers...
...Or is it the unions...
...In a hotel a maid comes in once a day to do the room...
...I know of no hotel that expects you to share a room with three or four other persons, or even with one other person, you have never met...
...Many hotels provide toothbrushes for guests who forgot them...
...part of hospitalization—room, food, furniture, and service—which remains beneath what a third-rate motel would dare to offer...
...But such minor conveniences are regarded as too expensive...
...It's fun and makes it easier to make up the bed...
...someone brings next day's menu, and picks it up later, after you have made your choices...
...2) Overstaffing and overpaying...
...to no avail...
...Not in hospitals...
...to empty waste-paper baskets...
...3) Around noon another man appeared to do the same for the bathroom...
...Yet it is overdone...
...Since hotels manage to make decent rooms available for less than $40 why should a room as such be more expensive to a hospital...
...Someone comes in at unpredictable times to make the bed, nurses hand out medications, or check on infusions, several times every day...
...Quite likely...
...Admitted in an emergency, sans toothbrush, I found the hospital did not have one...
...My stay cost my insurance about $600 a day...
...They have found infinitely clever ways to complicate matters...
...You cannot order your choice of food by phone and have it in your room when desired—although, unlike hospitals, hotels seem to master the art of providing this service to thousands of guests...
...They felt they could do nothing...
...Excellent gooseneck lamps are on the market...
...But it is the hotel and restaurant See my article "Bedpan Hospitality" in the December 1981 issue of The American Spectator...
...Why should sick people be expected to give up their privacy when sick, if they don't have to when healthy...
...But this medically outstanding hospital shuns conveniences...
...I never found out why...
...Or to do the room in a single operation...
...Are hospital administrators less interested in the comfort of their guests than hotels are...
...The remedy here is legislation providing full reimbursement by taxpayers for those who cannot pay...
...The simplest reform is to make sure that, however insured, the patient (except those below the poverty level) pays a percentage of the costs of hospitali zation and thus retains an interest in minimizing the expense which no third party will, or can, pursue as readily as he can...
...Five factors contribute to inflating the cost...
...And there are innumerable tests: hospitals are bloodthirsty...
...Morally the practice is unjustifiable...
...I found that the ordinary sleeping habits of patients are systematically ignored...
...Yet, there is no shortage of physicians available for residencies...
...Everything else could be as readily, and more comfortably, achieved by strategically placing pillows...
...BEDPAN HOSPITALITY (II) by Ernest van den Haag Recently fate offered me another unsought opportunity to serve as your involuntary hospital reporter.* As before, I found the medical services in the University-run hospital excellent, although there is an unexplained shortage of residents, the physicians who hang around twenty-four hours a day and are essential for emergencies and routine procedures...
...The cost to the hospital is a negligible proportion of the total charged...
...Once a week a charitable lady appears to offer to lend used, out of date magazines and paperbacks...
...So is writing paper...
...The rich were treated in their homes...
...How can this irrational and disruptive procedure be explained...
...There are far more people wanting these jobs than there are jobs to give them...
...Consequently one is compelled to wear hospital issue pajamas however much one prefers one's own...
...After all, patients should think themselves lucky to have been admitted...
...Which brings me to the bill...
...Nursing was competent though hard to get...
...He has no right to privacy...
...Why not have a more adequate number of residents then...
...In hotels, and even in some prisons, one may receive "conjugal visitors...
...I thought of getting an injunction, but he died before I could—badgered, literally to his last day, by the unwelcome visitor...
...2) Around 10:30 a young man appeared with a mop...
...Unlike the hotel guest, the patient cannot leave...
...needlessly, since there is a telephone...
Vol. 16 • May 1983 • No. 5
