The Chaos of Health Care Reform

Well folks, it has been quite a ride since we last visited our blog and the issue of health care reform. The process of "discussion" of options and plans has been chaotic and downright nasty. We are interested here in looking at the big picture. In the course of traveling that route, we have come across some very thoughtful articles that address various pieces of the puzzle. One of those pieces is the cost of health care and how to control it.

One article that we especially like is called 'The Cost Conundrum' by Atul Gawande. It appeared in the New Yorker in June 2009.

Here's the link. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

The author looks at the costs of health care in the U.S. He searches for the places that spend the most money on health care as well as those that spend the least. McAllen, Texas turns out to be one of the most expensive towns in the U.S. for health care. He also looks at models like the Mayo Clinic, which operate in various parts of the country, and Grand Junction, Colorado, a community which provides high-quality health care at substantially lower cost.

What accounts for the differences? After a great deal of digging, interviewing and comparing, he points to one particular issue and dividing principle. Rather than trying to maximize profits for the practitioners, the leading doctors and the hospital systems in the lower-cost places have found ways to reduce or eliminate incentives to spend more for the sake of maximizing profits. They also take collective responsibility for improving over-all patient care.

There you have it - one piece of the big puzzle. It is not easy to change an underlying philosophy and approach to patient care, but it has clearly happened successfully in some places and could be replicated and save lots of money without compromising quality of care.