Why Not the Best?
This is Victor Fuchs, writing in the New England Journal of Medicine:
There are, however, individual U.S. physicians and health care organizations that deliver high-quality care at a cost roughly 20% lower than the average. If the rest of the U.S. health care industry followed their example, health care spending would drop from 17% of the gross domestic product to 13%. Though that would still be well above the spending level in other high-income countries, $640 billion would become available for addressing other important public- and private-sector needs.
Doesn’t this fall into the true, but trivial category. With this information and a dollar I can buy a coke.
“Only” a 20 percent savings? Sounds like much less than the variation in health care costs geographically and by income and by payor — that is, whether the patient or a third party pays.
The quality measures in this analysis are suspect, since quality is in the eye of the beholder, not a universally-agreed-to metric (as price is).
It is generally accepted that in the United States about 30% of medical care is either unnecessary, has no therapeutic benefit or possibly even harmful. Yet, merely knowing that does not make the $640 billion wasted each year magically reappear. The only way to wring the savings out of health care is by providing doctors, hospitals and patients with an incentive to scrutinize costs and look for cost savings. In health care, what policymakers consider to be waste is revenue to providers. That is why it is so hard to squeeze savings from the health care industry. There are nearly 1 million doctors, hospitals and clinics looking to boost revenue; but few incentives to make them look for ways of saving money.
Has the NCPA studied the Lowes/Cleveland Clinic partnership? They’re only doing one procedure, but it seems to me like domestic medical tourism is a decent answer for containing costs.
When I did a project on international medical tourism, my group kept finding that there were low-cost providers in the United States. We couldn’t get around the fact that some American providers can cut costs and provide good care. If even one provider can do that, your incentive is to go to them.
Hospitals can cut surgical costs in 4 ways: 1) being in a low-cost area, 2) economies of scale, 3) high quality techniques (lower complication and readmission rates), 4) low cost supplies. If there is really that much low-hanging fruit, why aren’t more hospitals trying to find domestic medical tourists?
I gree with Bruce’s comment. Just knowing there are efficiency differences among hospitals doesn’t tell us how to make inefficent hospitals more efficient.
Right. And all the children in Lake Woebegone are above average. There will ALWAYS be high performers and low performers no matter what you do. And if we were all as smart as Victor Fuchs, we would all be idiots.