Throwing the Book at the U.S. Healthcare System

There is the kind of book that sits on your shelf gathering dust, and then there are the books that get dog-eared, underlined and utterly abused because they are used and referred to so frequently. Two such books crossed my desk recently, and I’d like to share them with you. The first, “Who Killed Healthcare? America’s $2 Trillion Medical Problem and the Consumer-Driven Cure” is penned by someone who needs no introduction to members of the ambulatory surgery industry — Harvard Business School professor Regina Herzlinger, who has been a long-standing champion of consumer-centric healthcare and the medical entrepreneurs who provide it. Getting quickly to the heart of the matter of who killed the U.S. healthcare system, Herzlinger points to what she calls an iron triangle of third parties — Congress, insurers, and hospitals — that has usurped power away from physicians and patients, the healthcare consumers.

She explains that Congress has harmed healthcare by not being content to merely approve the total budget, but instead it must also set prices for every procedure performed by every care provider, and lately, that includes telling physicians how to practice medicine. Herzlinger says that Congressional oversight of healthcare is akin to telling an artist to paint by numbers and giving every artist, be he a Monet or an amateur dauber, the same price. Herzlinger blames insurers for just saying “no” — to choice, to low payments, to provider incentives, and to those little extras so valued by patients and providers alike. And she blames hospitals for becoming monopolists who suppress price and quality competition in many parts of the country.

According to Herzlinger, the current dead-on-arrival healthcare system must be resuscitated and transformed into a consumer-driven health system which would give citizens more control over their choices of insurers and providers, and would provoke providers to offer better services and treatments at a price consumers are willing to pay, ultimately driving innovation and reducing costs.

The other book is “The Cure: How Capitalism Can Save American Health Care,” by David Gratzer, MD, who charges that the crisis in the U.S. healthcare system stems largely from its addiction to outmoded and discredited economic ideas. He points out that even as Americans are surrounded by medical miracles achieved through the trifecta of medicine, science and technology, Americans’ angst over healthcare has never been greater. In the book, Gratzer makes a provocative argument, rejecting the conventional wisdom that socialized healthcare is compassionate and that top-down government agencies like the FDA actually save lives. Instead, he prescribes a strong dose of capitalism. Gratzer insists that it is quite possible to reduce health expenses, insure millions more, and improve quality of care while not growing government or raising taxes.

Industry members will have the opportunity to hear Gratzer discuss how capitalism can save healthcare at the Outpatient Outlook 2008: The Future of Healthcare conference, to be held Feb.

24-26 at the JW Marriott in Tucson, Ariz. On behalf of the conference organizers I encourage you to join us as we peer into the future for a look at the biggest trends that will impact the operations of ambulatory surgery centers, cancer centers, imaging centers and other outpatient diagnostic medicine and treatment centers. In various roundtables, panels and presentations, an expert faculty will lead participants through discussion about everything from how the Presidential race will impact our industry, to the future of diagnostic imaging, the greening of healthcare, how to navigate the current legal, regulatory and reimbursement environment, and much more. For details, go to www.outpatientoutlook.com. 

Until next month, 

Kelly M. Pyrek 
Group Editor, Virgo Publishing Medical Group, 
kpyrek@vpico.com 

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