Sunday, December 21, 2008

Hospitals spending substantial resources fighting with each other

I don't know what to make of this yet but it's upsetting to me so I'm going to say something and leave it for further digestion.

I've been reading an awful lot about the enormous cost of healthcare in the US, and the various things people are doing to try and "transform the process" etc etc. Then I read stuff like this - stories of three situations in three states where major resources are being put into hospitals fighting with each other instead of getting the job done.

From well respected "Medical Quack" blog, Ducknet: How Hospitals Go To War - it's a hedge war with insurers.

Why is some of this happening, party because we let some of it occur, while the insurance industry (much like Wall Street) was busy investing in business intelligence software and working on their formulas or algorithms, much of healthcare was bliss trying to focus on healthcare. ... risk management is what runs healthcare today, not the focus of better healthcare as we are now observing a continuous downfall in all areas of healthcare when it comes to just getting taken care of. ...

As reported today in the Wall Street Journal, the pressures have even continued to accelerate with hospitals with having to sign up with Experian credit services, so before services offered can be considered, they are forced to look at the algorithms or formulas provided to hedge and see what the risk factor is if a patient will be able to pay.

From today's Boston Globe:
Fueled by profits, a healthcare giant takes aim at suburbs
Partners HealthCare's push has community hospitals running scared, and crying foul
Watch the 2 minute video at the top of that piece - a doctor who's been in practice for 40 years, now being paid 1/3 less for the same work than Partners gets paid, because of how the big chain muscles insurance companies. (That aspect was documented at length earlier in the Globe's series, causing a major uproar, including one Partners executive asserting that their costs are higher because their patients are "more vulnerable."

I understand business, but we're talking about people's lives here, including many many people being unable to afford insurance or healthcare at all because the costs are so high. (See below, and I'll write more about that here in the coming days.)

I'm starting to wonder how managers can work in a system that's become so messed up, so thoroughly removed from having any priority on caring for people. When I read those articles and then think about the many many people who have been ruined by the cost of healthcare, I get really sickened. Pardon the expression.

One things seems sure: the current system of care providers trying to bolster their own position, and put each other out of business, is free enterprise at its worst. Those articles talk about investor concerns, with little sign that these hospitals' boards are enforcing care quality. (To the contrary, the Partners organization has recently been found to be entirely ordinary, delivering lower quality care than the less expensive community hospitals it's apparently trying to drive under.)


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