(Mis)Managed Care
In the ideal world, you and your doctor would use the most modern techniques to record your health history, analyze your symptoms, determine what additional testing is needed, schedule and perform the testing, arrive at a diagnosis, and institute the most appropriate treatment for your condition. You might think this is the goal of your health care plan. You would be wrong.
Health plans take in money. They use some of that money to pay for care. The rest is used for salaries for non-health care personnel, advertising, real estate, executive salaries and perks, "retreats", and the like. The money spent on care is an expense, to be balanced against other factors.
In the realm of heath care, who or what is the problem? I suggest it is the illness or injury, not the patient, hospital or doctor. Health care insurers install all sorts of "games" to keep needed tests from being ordered and appropriate treatments from being administered. They create friction that slows the delivery of care. A persistent physician and patient can still usually get what they want, but only after expending time and effort. The insurer eventually relents and pays (after all, the insurer does not have a license to practice medicine). The considerable costs in pushing paper raises the cost of care without changing quality.
Friction is that which slows down progress and gums up the works. It is friction which causes armies to lose wars. Friction slowed delivery of aid to New Orleans. Friction is the ploy of bureaucrats. At best, it makes people adhere to yesterday's algorithms of care; at worst, it delays and obfuscates needed care leading to more disability and suffering.
No good rant should be without a solution. Managed care organizations should focus on mining their vast data banks to determine methods of care most likely to succeed and use this in an educational way. Rather than denying a test or a treatment, consider requiring longitudinal data collection. This data, combined with that from other caregivers and patients, can be used to create a knowledge base for education and for developing armor against those who attack the health care providers for failure to provide all that is wanted.
Managed care, in its current iteration, is as much part of the problem as disease or trauma.
Doing the right thing is always cheaper in the long run.
Health plans take in money. They use some of that money to pay for care. The rest is used for salaries for non-health care personnel, advertising, real estate, executive salaries and perks, "retreats", and the like. The money spent on care is an expense, to be balanced against other factors.
In the realm of heath care, who or what is the problem? I suggest it is the illness or injury, not the patient, hospital or doctor. Health care insurers install all sorts of "games" to keep needed tests from being ordered and appropriate treatments from being administered. They create friction that slows the delivery of care. A persistent physician and patient can still usually get what they want, but only after expending time and effort. The insurer eventually relents and pays (after all, the insurer does not have a license to practice medicine). The considerable costs in pushing paper raises the cost of care without changing quality.
Friction is that which slows down progress and gums up the works. It is friction which causes armies to lose wars. Friction slowed delivery of aid to New Orleans. Friction is the ploy of bureaucrats. At best, it makes people adhere to yesterday's algorithms of care; at worst, it delays and obfuscates needed care leading to more disability and suffering.
No good rant should be without a solution. Managed care organizations should focus on mining their vast data banks to determine methods of care most likely to succeed and use this in an educational way. Rather than denying a test or a treatment, consider requiring longitudinal data collection. This data, combined with that from other caregivers and patients, can be used to create a knowledge base for education and for developing armor against those who attack the health care providers for failure to provide all that is wanted.
Managed care, in its current iteration, is as much part of the problem as disease or trauma.
Doing the right thing is always cheaper in the long run.
posted by DocBrain at
7:57 PM
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