A bad hospital is hard to find -- and harder to close. Although America is losing hospital beds, too many subpar institutions remain in operation, partly because it remains difficult for patients to identify them despite a spate of new rating services.
These issues, both of which should be focal points of any upcoming health reform debate, are summarized in a New York Times article about a Syracuse hospital that's worth avoiding.
"Evidence shows that University...is not a good hospital," the article warns. The Niagara Health Quality Consortium, a good-government organization devoted to improving care, notes that the chances of a post-operative infection are 76% above the statewide average and the odds of dying of pneumonia are 56% higher.
These figures have been posted by Niagara but it takes tenacity to sort through the 31 different ratings, many of which show the hospital at the state average. Why not use a simple comprehensive rating like those typically used for hotels? When we travel, we're not asked to decide between a Holiday Inn that has plenty of hot water but a dingy lobby and a Ramada Inn offering an exemplary free breakfast offset by creaky elevators.
Other respected medical ratings aren't any better. Doing the same exercise at the Federal government's site gives the impression that the four hospitals in Syracuse are roughly equivalent. And the Leapfrog group, an employer-funded effort to drive patients toward high quality care, simply notes that University hasn't answered their questions.
None of these ratings mention that a state commission recommended that the hospital be merged with a nearby financially-troubled competitor, reducing combined capacity by more than a third. And none suggest the pointed negative conclusion of the Times article.
University remains open, aided by a $2500 per patient state subsidy, perhaps because it provides good jobs at good wages. The combination of the hospital and its parent, the Syracuse medical school, is the largest employer in the city.
So the hospital workers remain employed and its patients remain at risk. Once again - this often happens in public schools, too - the concerns of customers are pushed aside. It would be tough to change that attitude.
Medicine is one of the few areas of America's economy that continues to grow. That growth pushes costs up and fuels concerns. But events elsewhere in our economy explain why so many are so reluctant to take action to suppress it.