Neil McLaughlin's editorial on the worship of profits and paydays in healthcare is right on ("An embarrassment of riches," Dec. 19/26, 2005, p. 21). We have forgotten about the real bottom line-the health and well-being of our patients. The best argument for pursuing a national healthcare system is the sorry state of our current system, which has 46 million patients without insurance while healthcare organizations run up profits.
We could all benefit from the dismantling of the McCarran-Ferguson Act, which gives states the power to regulate insurance, and from congressional action against not-for-profits that clearly abuse their pricing practices.
Paying for improvement
I read with great interest Todd Sloane's editorial on pay-for-performance programs, and couldn't agree more with his conclusions ("Paying for improvement," Dec. 12, 2005, p. 20).
We are working very hard within our organization to ignite physician enthusiasm for this concept, which already affects our hospital clients and will eventually affect all physicians.
Admittedly, most physicians aren't enthusiastic about the idea of P4P, believing it will become "pay-for-cost containment" in disguise, but I believe real improvement can be made and paying for that improvement can work. We'll get there.
Chief executive officer
Not enough attention
The issue of public reporting of healthcare quality data has been around for a while, but has not developed as quickly or with as much publicity as I would have anticipated ("Getting satisfaction," Dec. 12, 2005, p. 6).
I have been surprised by the relative lack of efficacy of organizations such as the Leapfrog Group. Your cover story points out that not only the public, but also boards, CEOs and the CMS will be looking at publicly reported data. I am also taken by how little attention quality reporting has received from private insurers and employers.
People make the difference
I liked Melanie Evans' special report, "Waging war on inefficiency" (Dec. 5, 2005, p. 26).
In particular, I was taken by the example of North Shore-Long Island Jewish Health System, which expects to boost its annual laboratory revenue by 10% by improving the efficiency of its technicians and pathologists.
People make the difference in productivity. You can have the same equipment, same volume, but if you have not invested in hiring quality individuals to work the equipment, you are not going to be as efficient. Poor-quality staff leads to bloated payrolls and spending.
Chief operating officer
Vaughan Regional Medical Center