Health Care Thoughts: The Other Side of the Equation
by Tom aka Rusty Rustbelt
Health Care Thoughts: The Other Side of the Equation
Obamacare is in the news every day, with much discussion of jobs and exchanges and insurance and many other topics. My beat is the other side, the provider side, and a great deal of confusion and chaos lives there.
What are providers supposed to be doing?
improve quality
cut costs
install complex EMR systems able to link into EHR networks
work through a massive transition to ICD-10 coding
move into a complex “big data” environment
move to innovative delivery and revenue models
(ACOs, bundling)
overall, develop and implement new and unknown clinical and business models
So what’s the problem?
No one, in or out of government, can tell us what the destination is. This is a ginormous lab experiment with patients as the white mice.
Yeah, and a bunch of these goals will cost a tremendous amount in effort and overhead without necessarily doing much for patients. And a lot of it just seems to make the medical system more impersonal and dehumanizing and the patient more part of a data factory.
Improving staffing ratios would help hospital and nursing home patients (and employees) more than any of the above and is relatively simple and concrete. But this sort of progress is totally off the table.
Only progress that results in revenues for corporations (EMRs and so forth) is even discussable.
I do have sympathy for providers. The shift of risk to them involved in ACOs is scary.
a interesting portrayal of the big picture in healthcare
a masters thesis
The Medicalization Theory in a Discourse of Knowledge Product
ion under Neoliberal Conditions
“Neoliberalism increased the political and economic power of the private industry in research and has therefore changed the way
knowledge is produced dramatically. Analyzing these changes in knowledge production as a global phenomenon in general,
the thesis looksat medical knowledge production in particular. ”
http://othes.univie.ac.at/7869/1/2009-11-02_0255961.pdf
The real problem from the providers’ point of view is that improvement in coverage for the broader population is going to require reduction in compensation for many parts of the medical provider “system”. Many other parts of the economy have had to adjust to that problem. The simple fact is that the society cannot afford the providers’ prices.
Where is the real cost of healthcare – the salaries of the workers or the cost and associated charges for their equipment? Providers or suppliers?