Flutterby™! : Healthcare Waste 2012-09-06 19:37:49.919498+00

Healthcare Waste

2012-09-06 19:37:49.919498+00 by Dan Lyke 11 comments

The Institute of Medicine of the National Academies points out the obvious: We're wasting $750B/year and many tens of thousands of lives on our health care system, with horrendous outcomes when compared to most other modern industrialized nations.

Health care costs have increased at a greater rate than the economy as a whole for 31 of the past 40 years. Most payment systems emphasize volume over quality and value by reimbursing providers for individual procedures and tests rather than paying a flat rate or reimbursing based on patients' outcomes, the report notes. It calls on health economists, researchers, professional societies, and insurance providers to work together on ways to measure quality performance and design new payment models and incentives that reward high-value care.

I also realized something recently: Many of my friends are nervous about single payer health care. I've heard "do you want your doctor's office to be run like the DMV?". Before I moved to California, I would have answered "hell no", but here in the Golden State our DMV actually seems to be pretty well run. Maybe much of the fear of a consolidated government-run healthcare system comes from people who live in states that have poorly run government services.

Living in the most corrupt county of the most corrupt state of the United States I have often thought about switching governments too. I just think that I should be able to change service providers without moving.

I have a number of friends who have been considering switching governments. Not necessarily permanently, but they've moved outside the US for reasons which include healthcare.

Mark, I understand that but with the private sector there is a good chance that an alternative company will be available to change to. I find it difficult to change governments when I'm dissatisfied with the service.

The NY DMV used to blow a day getting new plates (every two years) or a new license every four. The change in processing as the result of both better management, and the utilization of the web is truly astounding. Going from an enormous room full of very angry people to a few minutes on line, and not much worse on the rare occasions you actually have to go physically to the DMV.

All it takes is someone with an MBA and Grand Ideas to do the same thing to an efficiently run company.

The Georgia DMV has a policy that if you wait more than (if I recall correctly) 20 minutes, your transaction is free. I never had a free transaction. I don't know the policy in Ohio, but the service is very satisfactory (to me) I went to an emergency room with a serious gash over my eye, a rag staunching the flow of blood, and waited for 2 hours for someone to take a look. Running an ER like the DMV sounds pretty good to me.

I think the other half of my conversion to Single Payer is using Kaiser for my healthcare. Bla bla bla free enterprise etc, but man that vertical integration means they just get it right.

Over the last ten years or so, the DMV (called Secretary of State) here in Michigan has gone from being the usual bureaucratic nightmare to the best-run department in state government, thanks mainly to the efforts of former SOS Terry Land. I wish hospital ERs were half as efficient. I don't see single-payer improving things.

Yeah, beyond the single-payer aspect, I hear people attack ~~Romney~~ObamaCare with the notion that it removes choice. That argument holds absolutely no water with me because unless you have several million bucks in liquid assets with which to pay for healthcare, you need insurance, and even if you do insurance makes sense because of negotiated prices.

And if you don't, then you're an externality that the rest of us are paying for, and part of the reason our healthcare is so dramatically over-priced.

Further, you may be campaigning hard against the notion that emergency rooms need to treat every emergency that comes in, and that's a consistent stance, but there are lots of situations where ID and proof of ability to pay are impossible to prove before stabilizing the patient, and there's no way that removing that restriction on emergency rooms is a political viable option.

So, yeah: Mandating that everyone carry health insurance is a completely reasonable public policy decision. Single-payer? As I look at the real numbers of what other nations accomplish vs what we do, I'm slowly becoming a fan.

And I suspect that part of the evolution of my opinion on that is that Tennessee has worse run state and local government than California.

If you've ever gone to the Emergency Room, you'll realize that hospitals are already run like the DMV. People are afraid the rest of the hospital will end up being run the same way under single payer. They don't realize that the emergency rooms will function much better if people are able to stop using them as the only source of health care.

I learned to complain about the poor quality of care I received as a child from the single-payer medical system the US current operates for military families. Then tom kunesh asked me if I ever went without care.

I realized how much better my health care as a child was because I had universal access. If I was at all sick, we just showed our military IDs and soon saw a doctor. I never had to stay the night in a hospital, but I know my parents never received a medical bill. Even our prescriptions were filled at the pharmacy in the hospital with no money ever exchanged.