Ambulances held hostage

[DrParasite]

Off-site part of the hospital system, and yes they are all placed in "strategic areas" (i.e. not ghetto).

As to the ER being a loss leader, it's still a part of the package. How many of those mega-bux cash cow inpatients made entry to that hospital through the ER.. I'm guessing that they, plus the price gouging that occurs to those who are in the ER with insurance generate than enough cash to offset the non-payers down there..

Then there's the grant funding they get

You are missing the point... no one ever claimed that hospitals weren't making money; however, emergency rooms, are not huge profit centers, at least compared to other departments. Some do lose money, but you're right, private insurance does pay off the losses sustained incurred by medicare, medicaid and underinsured

Emergency Department Profits Are Likely To Continue As The Affordable Care Act Expands Coverage

To better understand the financial viability of hospital emergency departments (EDs), we created national estimates of the cost to hospitals of providing ED care and the associated hospital revenue using hospital financial reports and patient claims data ...

www.ncbi.nlm.nih.gov

 

[DrParasite]

If ER's were ultimately losing money, then explain the proliferation of standalone ERs in the last 5 years.

That's easy... the ERs are in affluent areas, are able to treat people WITH private insurance, and are often seen as gateways to the main hospital. not only that, but those stand alone ERs are often surrounded by medical complexes with doctor's offices and other commercial properties that feed money back to the main hospital. having the free standing ERs is a PR bonus for the main hospitals, and if they do get a sick person, they CCT them from the satellite ER to the main hospital, often as an admission (I think the last stat I saw said that 25% of people who are admitted come through the ER).

In my town there are 3 major hospital systems, two privates and a public. Between the 3 systems, there has easily been $10B in upgrades/expansions in the last 5-7 years.

No one denied that hospitals haven't been spending money on expansions, especially since healthcare and hospitals are big business. the ER, however, is not one of those big revenue generating divisions

Hospitals are NOT running in the red, no matter how much they want to claim that they are..

And no one ever claimed otherwise. but you can't say that the emergent side of the hospital is more lucrative than the elective procedure section, especially when one provides guaranteed payment while the other doesn't.

 

[silver]

Generate, collect, tomato, tomato..

Don't misunderstand me, I'm not complaining about the US healthcare system, like I said I was just responding to the notion that hospitals are losing money, the amount of money that goes through a hospital in the way of billing, grant generation, residency reimbursement, charitable donations, and I'm sure other funding sources is simply staggering.

Looking at a hospital's 990 is kinda interesting. The margins are a lost slimmer than you'd think. There are years that some big, brand name hospital systems operate on a deficit and only stay out of the red through their assets (real estate, bonds, stocks etc).

Recently NYC Health and Hospitals had a $3 billion deficit that was supported by the city + state...There is a reason why so many hospitals are closing and none are opening.