“There is some good news about the overly costly, underperforming health care system.”
So begins today’s New York Times editorial entitled “Treating You Better for Less.” After reading the shallow piece, it hard not to stand in awe of their limited perspective and understanding of the complexity of reining in health care costs in America.
But these are the promoters of “experiments” to save money in health care:
“It is a measure of how dysfunctional the system has become that these successful experiments – based on medical sense, sound research and efficiencies – seem so revolutionary.”
What is dysfunctional is the administrative and third-party overhead in health care today. One only has to look at the examples given in the editorial to see what I mean.
The "editors" describe how Virginia Mason Medical Center in Seattle lowered their CT and MRI scans by 23-27 percent by forcing doctors to click through a “checklist of the medical circumstances needed to justify a costly imaging test.” What else did they do? They “sharply cut” the time needed to process insurance claims by “consolidating steps.” In other words, the hospital spent a ton of money on an EMR system that improved their collections and slowed doctors’ work flows. Fortunately, “Virginia Mason has been reporting margins of 4 to 5 percent.”
I'm seeing cost savings there, aren't you?
Which is exactly my point. Patients are not seeing these "savings." The system is. Our costs (need I remind anyone who pays a health care premium) have continued to skyrocket year after year after year.
But it doesn’t stop there. You see Virginia Mason has set up a screening program for their large corporate buddies Starbucks and Aetna to treat back pain. Imagine: “by finding ways to separate out the uncomplicated cases (can you say questionnaires and mid-levels) they figured that if they just send people to physical therapy rather than ordering MRI’s, they save everybody money!
Wow. Incredible. Millions "saved" there, I'm sure. Here's an idea, Starbucks: why not avoid the hospital system all together. Send 'em to physical therapy yourself! What's that you say? You're worried about liability risks? Oh, I see. Yeah, I guess that IS expensive, isn't it. But please, don't mention the need for libaility reform.
Even better: “Premier, Inc. an alliance of more than 2600 hospitals across the country has been testing ways to save money and improve care.” How have they done this? Well, the editorial claims they have “reduced unnecessary laboratory and screening tests” and “reduced labor costs by eliminating inefficient processes” by using “caseworkers and administrative assistants rather than nurses to call patients to remind them of appointment checkups.” Seems like another way to make sure people keep using the system to me. Tons of cost savings there! Seriously, how does an “alliance” of 2,600 hospitals save anything except lobbying costs on Capital Hill?
Even more egregious: “Premier reported in January that over a three year period, 157 of its hospitals in 31 states saved almost 25,000 lives and reduced health care spending by nearly $4.5 billion, roughly 12% of the total three-year cost of care at those hospitals.” Now I have to ask myself: what about the other 2,243 hospitals in Premier’s network? How’s their track record been? Might we be missing something?
It is increasingly difficult to find real, credible investigative reporting and objective commentary regarding health care “reform” in today’s main stream media (MSM) and scientific journals. The world of sound bites and spin in our rush to "save costs" have become more important than facts and data.
We are talking about health care in America. We are talking about the incredibly challenging task of reducing costs in health care while trying to maintain some modicum of quality in a system of self-serving interests that are much larger than those of the doctor and the patient. Jobs are at stake.
To me, cutting administrative overhead in our bloated health care system should supersede ANY efforts to claim we’re “saving” a paltry 25,000 lives by administrative fiats rather than altering the mano-a-mano health care given by real doctors and nurses who work tirelessly each day in America’s health care system. Believe me, they save many more than 25,000 lives each year across America. But we'll never hear that story, will we?
I might start asking myself who wrote today’s lead editorial in the New York Times.
Because it sure as hell wasn’t a real journalist.*
* Premier health's press release.
For another, more enthusiastic endorsement of Premier's corportate efforts: see The Happy Hospitalist.