Health Care BS

Comments 7

1. DrRich wrote:

   This analysis once again puts the lie to the primary tenet - call it an axiom - of managed care, pay for performance, and other management theories which hold that optimization of healthcare can be achieved by centralized directives. This axiom, borrowed from industry, states: “standardization of any process always improves outcomes and reduces cost.”

   This axiom of industry may hold when you are building widgets, but when you are providing healthcare to humans it decidedly does not. There are times - many times - where optimizing outcomes for patients INCREASES cost. The aggressive management of many types of cancer is just one example. When these occasions occur, one must choose between a process that optimizes outcomes (which is expensive) and one that holds down cost (and sacrifices outcomes, i.e., lives). In every place where there is centralized healthcare, the choice is clear - keeping costs down is paramount.

   The thing that burns me is not so much that the central authorities invariably choose cost over outcomes (though that does burn me). What is particularly annoying is that, having chosen costs over outcomes, they then invoke the axiom of industry to equate their vigorous efforts at cost reduction with improved outcomes, thus maintaining the fiction that outcomes are their chief concern.

   - DrRich
   GUTHealthcare.com
   CovertRationingBlog.com

   Posted 21 Aug 2007 at 3:20 pm ¶
2. Catron wrote:

   Amen. It will be interesting to see if the advocates of central planning will try to spin this to their advantage (they are very creative that way). More likely, they’ll just pretend the data don’t exist.

   Posted 21 Aug 2007 at 3:55 pm ¶
3. Matt wrote:

   Catron, YOU are an advocate of central planning. YOU support Medicare and Medicaid, you just want them to pay doctors more.

   If you were the free market libertarian you claim, you wouldn’t be talking about total expenditures on healthcare as a society any more than you talk about total expenditures on water and sewer. All that matters is what the individual spends, or at least that is all that should matter.

   As long as you talk in terms of a society-wide “system”, you’re not introducing the free market. You’re just arguing over the manner in which the govt. doles the product out.

   Posted 21 Aug 2007 at 8:50 pm ¶
4. Catron wrote:

   Matt, you’re raving again.

   Posted 22 Aug 2007 at 8:36 am ¶
5. Matt wrote:

   Have I misstated your position?

   Posted 22 Aug 2007 at 6:06 pm ¶
6. Catron wrote:

   Yep.

   Posted 22 Aug 2007 at 7:14 pm ¶
7. Marius wrote:

   of course this is a welcomed prize for the American health system. unfortunately, all the lives saved ( or prolonged) in the fight against cancer are lost elsewhere. overall, life expentancy is sensibly lower in US than in most of developed countries, infant mortality is also unexpectedly higher in the US. it would have been really shameful for US ( the country that indeed spends per capita by far more than any nation on earth)if we didn’t beat those pesky socialist Europeans at least at one important chapter of health care. another important one is smoking reduction where we also do better than the Europeans.

   US has still a lot to do to prevent and decrease the incidence of cardiovascular and cerebrovascular mortality and morbidity ( US remains the most afflicted nation from obesity, diabetes/insulin resistance syndrome, to decrease mortality and permanent disability from gunshot wounds ( and other forms of inter-human violence). we also lag behind West-Europeans in number of people dying or mutilated in automobile accidents.

   overall US health care system remains inefficient ( the ratio of expenditure to results remains poor compared with those of most other developed nations). no wonder if we take into account that close to 50% of health care cost resides with administration ( mostly insurance on one end and billing on other end) and legal services and not with patient care.

   an overhaul of the insurance system is badly needed. the debate state vs. private companies is less relevant at this point. in the end almost 45% of healthcare cost are through Medicaid and Medicare - so the government is still the bigger player on the medical service purchase market. and it becomes clear that the private insurance is not always working the way is suppose to…

   Posted 23 Aug 2007 at 5:25 pm ¶

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