Regarding FCC awarding up to
$400 million in rural IT grants:
I think this is a tremendous move on the Federal Communications Commissions part to provide funding for local hospitals.
In trying to compete with metropolitan-sized healthcare facilities, the rural system continues to struggle to provide state-of-the-art healthcare.
Having grant money available to link a rural hospital to physician offices, clinics, etc., would allow for a more modern approach to rural healthcare and even provide an opportunity for digital radiology and other online services.
Gregory WhiteDirector of public relations
Washington County Memorial HospitalSalem, Ind.
A truly different approach needed on healthcare
I cant help but smile as I read the various plans and approaches being advanced by political candidates and others supposedly in the know regarding how to reform healthcare. Cases in point are Sen. John McCains comments about costs and insurance coverage, and "William Jessees observations" about the need for more transparency in the processboth appearing in the Oct. 29 issue of Modern Healthcare.
The problem is that neither of these approachesnor any other I've reviewedacknowledges the one fundamental flaw in all of them, namely that they all have continued to be based on the principles of the basic free-market economic model: Buyer needs (or wants) some item or service. Buyer goes to the market, reviews the alternatives and selects the most favorable option. Buyer then decides if the price for that option is acceptable, and if so, pays for the item/service. Its generally a two-entity transaction.
In healthcare, however, those activities are split among threeor more entities, none of which have control over more than one component of the process. The patient buyer needs/wants the service but cannot unilaterally procure it. The physician buyer provides the serviceas the only one who canbut has no say over what it will cost or even if the service will be paid for. And the insurer buyer pays for the transactionsometimesbut does so, not based on market forces but on the insurance companys balance sheet and income statement. The caveat is that each of the three has a different stake in the process but does not control enough of the processs dynamics to unilaterally make that stake a reality. The patient wants his healthcare needs addressed; the doctor wants to practice medicine without traditional market forces telling him/her how; and the insurer wants to pay the least amount possible for the transaction.
With little, if any, positive constructive effort to reconcile the differences in their respective orientations, those differences can only continue to grow, creating even greater disparities in our healthcare delivery system. What is needed is not a reformation of the existing system but a brand new economic model that accommodates the realities of this process by effectively bringing all three together for some possibly gut-wrenching but necessary dialogue on how to better collaborate for the good of all. Remembering the definition of insanitycontinuing to do what youve always done, but expecting different results each timeperhaps its time to address the insanity of this system.
Roy E. BarracloughChief executive officer, administratorAllen Memorial HospitalMoab, Utah
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