Comment by jonwachob91 | Hacker News Reader

Comment by jonwachob91 | Hacker News Reader

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It honestly depends on the hospital system.

Florida Hospital - Orlando (the largest hospital in the U.S. by bed count and revenue) has been doing a lot in recent years to address this concern. They started by making the largest soda you could buy a 16oz (bottled or fountain), and have slowly phased out some food groups (such as fried foods) and have introduced entire cafeterias that only serve fresh vegetarian dishes. They have brought in community coffee shops that only serve fair trade coffee, and are working on setting up a food court type area that will house local restaurants that serve only healthy foods.

Florida Hospital Orlando is the Flagship hospital for Adventist Health, which operates 46 hospitals in the US and 26 hospitals/67 clinics in another 21 countries. It is a model that is being scaled to this other institutions.

FH Orlando isn't a hospital that is known for it's innovative care like the Mayo Clinic or MassGen, but it's size makes it a model for operations that these leading institutions follow.

> by bed count and revenue

Someone please back me up here, it is fundamentally sick to rank hospitals by revenue, right?

That's a pretty standard practice even in countries with single payer systems.

Some hospitals do get higher funding, raise considerably more donations, and since even in the most "socialist" EU and other SPS countries state hospitals are still allowed to provide private healthcare services some also higher revenue through the private route simply by having better administration and more prestigious alumni and or patrons.

There is nothing sick about it, a hospital with better funding and revenue usually can provide better treatment, even the most bureaucratic healthcare systems are not immune to market forces, if nothing else than some hospitals will be better at attracting higher ranking doctors and surgeons and every country, region or large city has the "best" hospital for a specific condition.

At the end even the most equalized healthcare systems are still operating in a finite resource environment, even if the only finite resource is the availability of the best doctor in the country or region, this means that some will be better than the rest, ranking them by revenue usually is an easy way to find out which one it is simply because it's usually directly tied to the quality of the medical staff they can employ.

Standard practice or not, it still just seems wrong to me - maybe that's just the part of me that believes that healthcare shouldn't be treated as a business.

Healthcare should very much be treated as a business since we have limited resources, you need to focus your resources where they would do the most good if not you will not like the results as everyone will walk around with perfect boobs and teeth but will die at 40.

You are more than welcomed to go and check into the lowest ranked hospitals in your country when you'll get ill, if not then it's a pointless argument at the end regardless of how well you think you equalize your system it will always have better and lesser hospitals.

In fact centralization of talent and resources has a positive outcome rather than a negative one since it doesn't have a major downside but a huge upside.

It's considerably better to have 90 average hospitals and 10 great ones than to have 100 average hospitals since in the 10% of the cases when a great hospital, doctor or surgeon is needed you will still have a place to go.

There is no real way of assembling an all star surgical team in every hospital in the city, not to mention a nation, so even if you would want to forcibly spread doctors (and there were a few countries that tried) and prevent private funds the only thing you get is a worse healthcare system not a better one.

I don't think so...

It's a pretty good indicator of operational efficiency.

But to be fair, Becker's has a list for almost everything in a hospital [1].

Also, FH Orlando and most of the other hospitals that dominate the list by revenue/bed size/etc are all Not-For-Profit institutions.

[1] http://www.beckershospitalreview.com/lists.html

That shocked me a bit too, but then... 'murica.

introduced entire cafeterias that only serve fresh vegetarian dishes

Except that humans didn't evolve to eat a vegetarian diet and it isn't healthy for us.

I'm sorry. I was unaware I said they restrict you to eating vegetarian. To service the entire system they have 10 cafeterias across the entire hospital, not including the independent providers that operate on the campus (such as the Wendy's that isn't allowed to serve bacon).

The one vegetarian cafeteria is about making the option available to those whom desire it. The food quality is also much higher.

It would be great if they provided quality non-vegetarian food as well.

That's the goal of the food court that they'll finish in the next few years.

That makes sense, as offering a "vegetarian" menu is certainly cheaper and easier than actual high-quality balanced nutrition.

It always amuses me to see "vegetarian" used as a Pavlovian trigger to subconsciously suggest healthfulness. In fact, vegetarian food is often just as laden with starch, sugar, and trans fats as any Wendy's bacon burger.

There's a very similar phenomenon with "organic" - it automatically suggests "healthier", when in fact the pesticides used on organic crops may be even more harmful. More corporate green-washing.

I'll give the benefit of the doubt to your Florida cafeteria until I have a chance to try it, though.

I'm fairly sure the giant piles of salad I eat regularly have very little starch, sugar, or trans fat.

Of course it's possible to make and sell bad vegetarian food, but suggesting that it's "often" just as bad as non-vegetarian food is simply nonsense.

People become vegetarians for all kinds of reasons. I became vegetarian when I learned enough about industrial meat processing to decide that I had absolutely no interest in eating anything that came out of it.

It's much harder to fuck up a salad or a grain/rice/nut thing than it is to disguise the presence of pink slime or some other random body part slurry that most people wouldn't touch if they saw it being made.

It's much harder to fuck up a salad or a grain/rice/nut thing

I suggest that the ideas of salad and grain have become normalized in our culture, and have taken a sheen of healthfulness beyond their nutritional efficacy. Some greens with a little oil and vinegar: sure. But I see people buy pre-packaged salads from Trader Joe's full of fried noodles, corn, croutons and sweet creamy dressing quite commmonly, apparently under the illusion this is more healthy than meat. And any kind of refined starch (wheat, rice) plays a huge role in diabetes and other modern diseases.

If eating vegetarian is the worst thing that happens to you in hospital, it's been an OK visit.

It can be healthy if done right http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-he... It is probably a huge improvement over the crap you find in many hospital cafeterias.

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