American healthcare has had some interesting twists and turns during the economic recession and hospitals are reporting fear and budget motivated decisions regarding surgery. Many people eager to save their money are deferring elective surgeries such as knee replacements or cosmetic procedures. The problem is twofold as postponed elective procedures (treatment and screening) can lead to deadly consequences, and economic struggle undermines hospitals' ability to philanthropically serve the rising number of needy patients in communities. Even hospitals with ORs booked months in advance predict a slowdown in the second half of 2009.
There are many instances in which elective procedures are life-saving, and even necessary. Colonoscopies, for instance, screen for polyps that could develop into tumors. If not identified and treated, bouts of diverticulitis can perforate the bowel, which then requires a much more complicated surgery which carries greater danger for the patient and has a longer recovery time.
Not only is the health of individual Americans to be considered, but the stability and effectiveness of hospitals is also on the line. Elective procedures often have a high impact on hospital finances. While elective admissions might only represent 10 percent of the hospital?s admissions, they could represent 25 percent of the institution's bottom line. The reason is that elective operations tend to be covered by private insurance carriers which usually reimburse hospitals and doctors at higher rates than Medicare and Medicaid. According to Michael A. Sachs, chief executive of Sg2, a health care consulting firm ?They?re the patients that subsidize the underfunding associated with Medicaid and Medicare patients and uncompensated care.?
Revenue losses in the healthcare sector are forcing many hospitals to reduce staff, and postpone expansions and equipment upgrades. In November, the American Hospital Association reported that about one-third of U.S. hospitals had seen a moderate or significant decrease in elective procedures over the three months prior. More recent studies in local areas in New Jersey and Georgia move that figure closer to 50 percent.
Plastic surgery has been the type to drop most steeply, as it is usually not covered by health insurance plans. Dr. John W. Canady, the president of the American Society of Plastic Surgeons, reported that business off by around 30 percent among his members, especially for surgical procedures. During stable, successful economic times that decision to spend $2,000 on elective surgery merely takes money from recreational household funds, but during a recession, $2,000 could be the difference in whether a person can continue to make mortgage payments, and the surgeries are put off.
Rather grimly, there has been more interest in Botox and other minor cosmetic procedures from middle-aged patients who feel they need help when competing for jobs against younger applicants. Furthermore there has been a slight trend in which people fearful of losing their jobs and consequently their health insurance, are speeding up non-urgent operations.