It is impossible to scare audiences at this point; everything has been done. Gone are days when Hitchcock could have pulled off a 'Psycho' twist, or William Castle his publicity stunts. At this point, all we can hope for are well-made films, as everything has been done with the genre. There is no new ground to tread.
*****
On a disconnected note, I rewatched the remake of 'House on Haunted Hill.'
It has a nearly flawless cast: Janssen, Gallagher, Kattan, Rush, and of course, Combs, in his limited role. Each had their memorable scenes, but no arcs of development. I found the two survivors of the film - the fake executive and the ball player-to be quite annoying, though. I kept hoping they would be offed in the first reel, even though I knew it was not going to happen.
I enjoyed the title sequence and the film's fascination with 1930's culture and design (esp. Art Deco) and pre-modern medicine. However, I feel that the aesthetic is inconsistent: take the opening the scene. It starts from the Industrial Horror (think 7even, but using it to renegotiate 1930s designs,) to Lynchian cinema (the close up of the doctor blowing the shreds off the pencil,) to 1970s exploitation cinema (the pencils through the neck.) Then, it cuts to newsreel and then Unsolved Mysteries style program. In this scene, we go through five different aesthetics; I think if Malone had settled on one - for it and the film-it would have worked better. Afterwards, the horror alternates from German Expressionist, Industrial Horror, and then Splatter/Exploitation. If he had settled on two, I think it would have been a magnificent film. As it stands, it's a competently made film; what makes it frustrating is the potential in the film that pops up a lot more than one would expect. There are moments of brilliance: the TV host video taping Vannacutt conducting surgery; the mass of the asylum's spirits (which recalls the one Elm Street film where Freddy consumed the souls of his victims); and the Giger/Merhige influenced monsters.