Newly appointed as Secretary of Health and Human Services (HHS) replacing outgoing Secretary Kathleen Sebelius, Burwell's greatest asset may be her W. Virginia origin. Certainly Harvard and Oxford are impressive along with Gates and Clinton.
There may be no way to make it otherwise, but leading us out of the mess we are in as a medical profession, requires both clinical savvy, macro economics, vast clinical experience and leadership. Without vast clinical experience, I see no way to fathom the cause of the medical problems or to address the dismal ranking of US medicine in the (GBD) global burden of disease.
Disincentives, built into nearly all past bureaucratic efforts to control cost, stifle progress at nearly every turn.. Privatization, incorporation, insurance and standardization opens the purse strings -- the feeding trough, if you will -- to greed, exploitation and a welcome mat for any and all new gimmicks, technologies, drugs and procedures with a price tag set by the producer.
Never mind the shiny new hospitals that are not even clean inside, have only fractional bed occupancy but discharge patients before it is safe -- all due to the profit motive. Medicine is not a business. It is not a free market; it requires science, dedication and humanity beyond the capacity of most outsiders.
But given all of that, I wish Burwell good luck. I wish I could say more, but in the words of one of our pioneer family physicians here in Alaska, "A clinical doc has less then zero influence in academia and on bureaucratic regulation."
There may be no way to make it otherwise, but leading us out of the mess we are in as a medical profession, requires both clinical savvy, macro economics, vast clinical experience and leadership. Without vast clinical experience, I see no way to fathom the cause of the medical problems or to address the dismal ranking of US medicine in the (GBD) global burden of disease.
Disincentives, built into nearly all past bureaucratic efforts to control cost, stifle progress at nearly every turn.. Privatization, incorporation, insurance and standardization opens the purse strings -- the feeding trough, if you will -- to greed, exploitation and a welcome mat for any and all new gimmicks, technologies, drugs and procedures with a price tag set by the producer.
Never mind the shiny new hospitals that are not even clean inside, have only fractional bed occupancy but discharge patients before it is safe -- all due to the profit motive. Medicine is not a business. It is not a free market; it requires science, dedication and humanity beyond the capacity of most outsiders.
But given all of that, I wish Burwell good luck. I wish I could say more, but in the words of one of our pioneer family physicians here in Alaska, "A clinical doc has less then zero influence in academia and on bureaucratic regulation."
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