An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

by Elisabeth Rosenthal

Facility fees were a logical outgrowth of a period of rapid scientific progress in medicine, which allowed many treatments to move to an outpatient setting. Improvements in anesthesia, pain medicine, minimally invasive surgery, and biopsy techniques meant that many procedures and operations could be safely performed without an overnight stay. New medicines to quell the severe nausea of chemotherapy meant patients could receive treatment at an infusion center. Because hospitals had traditionally charged a day rate for inpatients, it made some sense that insurers (including Medicare) had largely accepted their new practice of charging facility fees for major outpatient care as well by the turn of the century.