Regarding Room for improvement on the cost side ":
While we can all agree that costs are an issue to be scrutinized, healthcare, unlike almost every other industry, faces additional challenges. There is not a direct supply-line model like other industries. Physicians and patients, neither of whom is controlled by the healthcare system, seek services that are costly on a per-encounter basis. Hospitals, imaging centers and other providers in the healthcare chain simply provide a requested servicealready agreed upon by organizations outside the supply chain. Third-party payments have disrupted the cost/value equation, and malpractice claims are always in the background for physicians. And then there is the issue of indigent care.
GM and others are not asked to give away cars without their consent because someone needs one. In healthcare that has become an expectation, and that cost shift once again drives an imbalanced system of nonrelational charges and payments. And contrary to many industries where services can be outsourced to foreign offshore companiesat significant savingsmuch of healthcare is local, with local wages, local healthcare worker shortages and all the costs the system incurs by not being able to have car tires made in Brazil.
Bernard J. Emkes M.D.Medical director Managed Care ServicesIndianapolis
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