Finding a solution is infinitely harder. Until fee-for-service is completely revamped, the problem will never go away:
The problem is not that doctors don’t know that the system is poorly run. The problem is not that the hospitals don’t like to be organized. The problems with healthcare stem from a multitude of self-interested parties who are all fighting for their part of the pie. The money in healthcare is huge and is rewarded most to those who cost the system the most (the insurance and drug industries). A system that rewards over-use of resources will never become efficient; there will always be competition over the money and always an emphasis on quantity over quality.
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{ 3 comments }
The article that the paragraph is drawn from above makes a lot of sense–except that it doesn’t accord with reality. I worked at one of those big clinics–over 200 docs of every specialty. It owned it’s own HMO and was capitated for the care with all the docs talking and working together. Good quality of care. But cheap? Well, at first it seemed more efficient, but by the late 90’s it nearly went under in red ink, had to dissolve the partnership, sell the clinic to the hospital, and sell the HMO.
Everyone persists in the fantasy that we will somehow have our cake and eat it too, but the fact is, Americans are healthcare gluttons and every advance in technology only exacerbates that. Even all the ranting about improved efficiencies to be had from EMR is so much hogwash. It makes the medical record department more efficient, but when systems are created to monitor and improve care, what happens is that all kinds of tests and treatments called far in the guidelines that are not currently being provided are identified, people are called in and provided the care they were neglecting. That means more cost.
And no, you don’t save money for the system by keeping people healthier. The people who save money for the system are the ones genetically destined to be healthy who just stay away from the clinic. Good care keeps sick people alive longer which costs more money. The unpopular truth is that the most efficient healthcare system is the one that let the weak and sick die with as little care as possible. So lets beware of always calling for more efficiency.
Whoa. Brutally honest, but true. What the last poster said.
5:23,
Truth and Ditto’s. I am glad that I am not the only one that understands that picture.
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