Sunday, June 14, 2009

Health care costs part 2

Noted with some self satisfaction that the NYT editorial page finally caught up today with BobOnARoll re: The New Yorker health care cost piece I cited in a post last week.

The magazine article is well worth your time if you haven't tuned in yet.

No satisfaction taken, however, in the lack of solutions offered by the NYT (or BobOnARoll). The cost control conundrum requires a leap of innovation, perhaps along the lines of assigning responsibility and accountability for healthcare spending to local oversight 'czars' whose compensation will be based on quantitative measures and qualitative outcomes.

Gawande describes a critical observation in the article that most doctors and other health care professionals are clueless about how their spending metrics compare to other docs or other communities. Nor are they ranked or evaluated on health and wellness metrics that equate to success in the field.

Rigid cost controls won't work and will result in rationing and chaos akin to what we now have. But a good start might be to establish standards and provide regular dataflow and feedback to docs about performance relative to other docs and facilities in the region and across the country. Digital medical records are a necessity to begin to accomplish this goal.

1 comment:

  1. I read the article. Thanks for the recommendation. It send to me that getting doctors to work cooperatively on salary rather than acting as profit making silos is a cultural challenge. Somehow the Mayo clinics and other cost effective systems have to become the desirable jobs for doctors rather than the McClean hospitals.