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Saturday, March 20, 2010

Should It Be Health Care Reform …. Or Health System Reform

The issue of health care reform has little to do with the incendiary issues of partisan politics or rights of access, but instead should be squarely focused on creating an effective, properly managed program.

In other words applying some common damn business sense .... like small business folks do EVERY day!!!!

What do you think?

IMHO ….. placing the emphasis on access is a classic example of putting the cart before the horse.

The primary barrier to access is cost. Address the cost question and the access question becomes academic. If it is affordable, it becomes by definition accessible.

And, if it is affordable, it can be extended to those without the means to pay for it at a reasonable cost to the taxpayer.

The system is clearly broken. The current efforts at reform place far more emphasis on treating the symptoms rather than on the real problems - waste, inefficiency, corruption, ineptitude, and a firmly entrenched health care establishment that benefits from maintaining the status quo.

That would suggest the need for "an effective, well managed program".

The question becomes, who would create it and who would manage it?

From what we've seen so far, expecting Washington to do it would be somewhat unrealistic and expecting the health care industry as a whole to reform and restructure itself without outside intervention would seem to be equally unrealistic.

The engine that drives change in the health care system or any other system is ultimately the people who pay the bills - the employers who currently pay for the insurance along with the individuals who consume the services, pay all or part of their own health care costs, and/or pay the taxes that subsidize the delivery of the services to those who cannot afford them.

There is growing evidence that the engine is beginning to rev up. Interesting things are beginning to happen, not quickly enough to be satisfying enough to anyone but the snowball is definitely beginning to roll down the hill.

It would be reasonable to assume that the health care system will undergo a dramatic transformation during the next decade as those who pay the bills become more sophisticated, cost-conscious, demanding consumers who turn to suppliers who will supply the right products and services at the right prices - and that the changes that take place won't be the result of any government program or epiphany within the health care establishment.

Thus, the most effective "program" might be private initiatives that focus on consumer education and provided incentives that would encourage the development of innovative, cost-effective health care delivery systems.

The message to the health care establishment would be - wake up guys, you're pricing yourselves out of the market!!!!!!!!

Here's an out of the box V8 moment for you ..... we should focus on applying lean methodology to improve the quality of care while reducing waste and excessive costs. Too many preventable errors occur in most hospitals and the health care system in general. And I’ve heard doctors candidly admit that (depending on the doctor) anywhere from 30% to 50% of their activities have nothing to do with the delivery of care. Attacking the sources of such waste will improve health care delivery, lower costs, and thus make care more affordable.

A number of hospitals, academic medical centers, primary care clinics, dental practices, and other health care facilities are adopting the lean techniques developed in industry to improve the delivery of care while lowering costs. BTW, lean is more than a set of tools for improving quality. It’s a management system that works any place work is done, where managers and employees are trying to solve problem, places like health care.

There are examples here: Health Care Value Leaders

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