Hughesair (Inflection Point)

Retired physician and air taxi operator, science writer and part time assistant professor, these editorials cover a wide range of topics. Mostly non political, mostly true, I write more from a lifetime of experience and from research, more science than convention. Subjects cover medicine, Alaska aviation, economics, technology and an occasional book review. Globalization or Democracy documents the historical roots of Oligarchy, the road to colonialism and tyranny

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Friday, April 27, 2012

Healthcare Waste

Certainly the need is urgent to bring down cost for both public and private patients.

Donald M. Berwick is affiliated with The Rand Corporation and he makes graphically clear six ways that our healthcare system fails us. In the order of significance, he lists administrative complexity, over treatment, fraud, overpricing, lack of good care, and lost continuity of care as patients fall through the cracks of over specialized and overcrowded doctor populations.

I would add another -- that also may be considered a pricing failure -- and that is government imposed pricing regulations that prohibit free or reduced price for needy patients. As a result, everybody gets the maximum charge whether they can afford it or not. ---

Furthermore, missed diagnosis and wrong diagnosis adds yet another layer of added cost, waste and morbidity to the mix. Dumbing down the provider education system to get more providers -- and a strategy of letting private insurance companies through free market practices, solve the problems -- seem to be further major mistakes.

Berwicks contends that solving the waste can bring accelerating healthcare cost down to the level of the cost of living curve. It could do much more if it were to improve the quality of care.

JAMA April 11, 2012-Vol 307, No. 14 features Donald M. Berwick's essay, Eliminating Waste in US Health Care.

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