Tuesday, October 14, 2008

Best Care Anywhere, part 2a

Updated 10/16... see italics: changed "letting people" to the more-specific "letting providers or insurers," which is much more on point.

In Part 2 I mentioned that one factor in the VA's results is that they're "stuck with" a patient for life. I meant it somewhat glibly, but later I realized I wrote about the same issue from a different angle way back in December, in one of my very first posts: For prettier statistics, omit inconvenient people. It's a long post, and something of a rant, but in short it says that a planner can come up with really nice pricing plans, etc, if you allow excluding the hard parts. I related examples from the health insurance industry from my own experience and friends'.

But isn't it ironic that when you're not allowed to exclude the tricky parts, costs can go down?

This is really interesting, because if you tug at any one part of the system, it seems like a morass (as I commented last week on e-patient). But it appears that if you insist on including the whole puzzle, it becomes solvable!

Preliminary wonderment: could it be that the principal principle (!) at fault is the idea of letting care providers, or insurers, say "Not me" to particular parts of the problem? I don't know. I don't believe in lots of legislative forcing, nor bureaucracy. But I know first-hand (as does the author of this book) that things have not been working out well in healthcare, left to the free market.

Next in the series

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