Regarding “Blues to stop paying for ‘never events’ ”:
This movement is discriminatory against sick people! Who gets pressure ulcers? The elderly, diabetics, people who are gravely ill with a number of other diseases. They will not be admitted, or will be transferred, by secondary-care hospitals. This approach is typical of a national mindset that will not fund healthcare adequately, and will then punish providers and hospitals when the results of understaffing and increased complexity of disease are manifest.
Steven Wolfson, M.D.
New Haven, Conn.Consumers need information
to make healthcare decisionsI’m writing to respond both to Janet Trautwein and to Dr. Don McCanne’s comments on the pros and cons of the U.S. moving to a single-payer model for universal healthcare coverage.
I agree with Trautwein’s position that free-market competition is likely to produce a better result than a single-payer—e.g., government—model. There are numerous examples in the U.S. where government-dominated industries have repeatedly been cited for their lack of efficiency and quality, most notably education and the military. Real competition motivates innovation and performance.
It is unrealistic to assume that any country, including the U.S., would ever sanction healthcare as a completely unregulated free-market industry. In almost every country, healthcare is one of the most highly regulated industries precisely because of its importance. Here McCanne is a bit off-base in blaming the shortcomings of healthcare coverage in the U.S. on the free market alone. The current healthcare model in the U.S. is best described as a mixed model, with significant government financing and regulation, and not a pure free-market model. The issue is more one of how to best regulate the industry to improve performance and quality.
In this regard, state and federal regulators are only now beginning to embrace their role as facilitating the flow of information to consumers and helping them to make better healthcare purchasing decisions. The lack of such information has been one of the major obstacles to this, and regulators have taken a increasingly positive role here in mandating such disclosures by providers as a condition of licensure and federal program participation.
Private payers have a place in this model, albeit under appropriate regulation. Their support can facilitate the development of efficient integrated-care pathways so that they can offer to their customers the most efficient care for their medical needs at a level of quality consistent with what the customer is willing to pay for. This type of choice is not a characteristic of government single-payer systems, where the working assumption is that one size both fits all and is good enough for everyone.
Until consumers are equipped with the information needed to make responsible healthcare decisions, moving to a government single-payer coverage model will only increase our already burgeoning rate of spending on healthcare.
William P. Springer Jr.
CPA, MBA Fellow, Academy for Healthcare ManagementThe Health & Wellness InstituteProvidence, R.I.
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