There have been many arguments put forth similar to Jason Millers (Guest Commentary, Healthcare costs in the eye of the beholder, at modernhealthcare.com). The essence of his argument seems to be that we consumers have proven ourselves willing to spend thousands of dollars on Super Bowl tickets and other relatively frivolous pursuits, and as a society dont blink at $100 million annual earnings for athletes and celebrities we admire, so why should be blanch at the costs of healthcare, which delivers so much benefit to all?
One of problems with this argument is that healthcare doesnt quite deliver benefits to all, since 47 million are uninsured, though admittedly some of them who are not can afford all the healthcare they need, while others who are insured cannot.
But the real problem with the many efforts by providers and their associations to justify our current healthcare system as a good value for the dollar ignores the underlying reality that we should not have to pay nearly as much as we do. The biggest source of waste is our general unhealthiness, caused partly by the fact that we dont have to pay the full costs of care, with health, disability and other forms of insurance covering our indiscretions.
But the waste in terms of inefficiently delivered care, which only half the time involves appropriate care, is equally at fault. There is no excuse for 100,000 avoidable deaths a year, countless avoidable errors, infections, never mistakes, and general inability to adopt the measures and make the investments needed to do better. As consumers learn just how poorly the worst providers operate, along with how much better the excellent ones do, they may ultimately shift their business in the direction of excellence, and drive the poor performers out of business, but it rarely happens now.
An even more positive scenario would be for all the stakeholders to get into the business of health. Providers are already adding retainer or fee-for-service health maintenance and improvement services to their practices, often balancing them about half and half. Many hospitals and integrated health systems are offering wellness institute, preventive medicine centers, and similarly proactive-health/prevention-focused programs to consumers and employers, and even to government insurers such as Medicare even though it has less money to save from improving beneficiary health than do employers through improving employee health. When compared with what our misnamed healthcare system could do if it worked with payers and consumers to focus on prevention and wellness, the current system is anything but a bargain, and far short of what the best system we could create would look like. Any beholder who fails to see this horrendous gap just isnt looking.
Port Ludlow, Wash.