Monthly Archives: July 2014

Self-Serving Interests

Health care has become bloated.  The system has become incredibly complicated and unfortunately there is no clear answer as to whether or not the complexity has any benefit.  Or if the small amount of benefit is worth the cost.  The reality is that there are a lot of people making a living in health care performing and providing services which probably contribute little to value for patient care either at an individual or systems level.  We can not ignore the fact that there is a lot of money in this system and that not everyone may be in the health care system for the same reason.  Not meant to be judgmental.

As we move toward trying to improve this broken system there are so many “stakeholders”.  Patients, physicians, other providers, hospital and insurance administrators and managers, medical device and pharmaceutical companies, politicians and the list goes on.  Everyone has an opinion on how to make things better.  Most have never had direct contact with a patient.  And everyone has interests to protect.  It is a difficult issue to discuss but how do we eliminate interests that are simply self-serving?  The path of least resistance would be to simply ignore this issue.  Just avoid any potential conflict and keep on with business as usual.  However, these are tough times for health care.  Tough times require tough people to make tough decisions.

The mission will not be easy.  The rhetoric is intense.  As is often the care the most intense rhetoric is often used to distract from a lack of substance.  How are we able to separate genuine good intentions from purely self-serving and economic motivation?  Everyone gives the appearance of taking the high road.  Is it genuine?  Is the message to the public from each stakeholder the same message that is given to shareholders and others with a financial stake?  In other words are the motivations and intentions of all of the accessory personnel (essentially anyone who doesn’t come in contact with a patient) aligned with the motivations and intentions of physicians and other providers?

In a previous post HCR proposed that all reform initiatives be scrutinized to the same degree as medical practice (Evidence Based Medicine, Evidence Based Reform?).  We are not in a position to be throwing money at new ideas that someone thinks is a good idea because it works in another industry.  With quality and cost as the primary metric each and every new idea needs to be scrutinized.  Forget the sales pitches and the hype.  Ignore the rhetoric.  Someone needs to be able to see through all of the smoke and mirrors that are simply protecting self-serving interests.  And we should not invest in anything that is going to result in a trivial incremental change.  Chances are it won’t be worth the cost.

While we are at it we should also look at the current system and begin to trim the excess using the same principles.  In a previous post HCR proposed having everyone account for their existence and paycheck (Tell Me What You Do Again and Why It’s Important?).

Is it wrong to questions people’s motives?  Absolutely not.  Is it difficult to question people’s motives?  Yep.  But it’s just a reality that we have to address in health care sooner rather than later.