The latest Freakonomics episode, “How Many Doctors Does It Take to Start a Healthcare Revolution?” Jeffrey Brenner, executive director and founder of the Camden Coalition of Healthcare Providers, uses Princeton, NJ as an example of over active hospital financing. The Coalition is currently working JPAL on an RCT of an care management program targeting healthcare system “super-utilizers” identified by healthcare “hotspotting”. From the transcript:
BRENNER: One of the problems is that we have a giant economic bubble underlying this where we have hospital financing authorities underpinning, that are run by states that help hospitals float bonds. And we have this giant bond market called the hospital bond market that’s considered very secure, very safe, good investment. And you know, that bond market has floated too much hospital capacity and created and brought online too many hospital beds, far more hospital beds than we need in America. So you know, the most dangerous thing in America is an empty hospital bed.
In the center of New Jersey, near Princeton, a couple years ago, we built two brand-new hospitals. These are two $1 billion hospitals, 10 miles apart, very close to Princeton. So one is called Capital Health, and the other is Princeton Medical Center. I don’t remember anyone in New Jersey voting to build two brand-new hospitals. But we are all going to be paying for that the rest of our lives. We’ll pay for it in increased rates for health insurance. And, boy, you better worry if you go to one of those emergency rooms, because the chances of being admitted to the hospital when there are empty beds upstairs that they need to fill are going to be much, much higher than when all the beds are full–whether there’s medical necessity or you need it or not. So I’d be very worried if you live in Princeton that there are now two $1 billion hospitals waiting to be filled by you.
The RCT is fascinating, but also interested me since I spent two years volunteering with Princeton First Aid and Rescue on the ambulance taking patients to the $520 million Princeton Medical Center, opened in 2012.1 I do not recall taking anyone to the Capital Health Medical Center – Hopewell, opened in 2011, but Capital Health Regional Medical Center in Trenton was our go to trauma center. To get an idea of the layout, the map below shows the Regional Medical Center in red, the two new hospitals in green, and the old Princeton Medical Center in Orange.2