Does Cost Equal Quality?
Does Cost Equal Quality?
A recent article in The New Yorker titled “The Cost Conundrum,” seeks to answer the question of the connection between healthcare cost and quality through a case study of one of the most expensive health care markets in the country. McAllen, Texas, has one of the lowest household income averages in the country at twelve thousand per capita a year, yet, in 2006, Medicare spent almost twice the national average on expenses per enrollee, to the tune of fifteen thousand. What caused this extreme unbalance in healthcare expenses? Were the citizens simply less healthy? Or were they just receiving much better care?
Through contrasting the town’s overall health and quality of services offered with the much less expensive health care market of the similar demographic in nearby El Paso, Texas, one thing became clear: there was no actual difference in the overall health of the people and the quality of care being received despite the overuse of medical tests, surgeries, home care, and prescription recommended in McAllen. When presented with a similar problem, doctors in the lower cost areas were more likely to seek the minimum treatment while doctors in the high cost areas opted for the maximum, with similar survival and satisfaction rates in the end.
The difference seemed to stem from the financially competitive tone being set by the practitioners in McAllen and similar high cost areas. McAllen had become an example of the “business” of health care in which doctors sought to maximize their incoming revenue through partnerships with hospitals, over recommendation of medical care and treatment, and competition through private practice. In contrast, lower cost areas promoted a climate of accountability and cooperation through collaborative organizations that are willing to sacrifice potential streams of revenue for quality of care. Though it is hard to picture anyone passing on revenue in these economically trying times, example organizations such as the Mayo Clinic have proven that by taking away financial incentive through pooling finances and providing a set salary, it is possible to encourage the quality of care while keeping costs down. Perhaps, the article argues, the key to cutting down the soaring health care costs is not through changing who provides the dollars behind the service, but instead, by changing the way those dollars are earned.
To find out more about the argument presented in this article, read the original at the following link:
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=1
- By SHOUTAmerica
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Reagan15
This article invokes a lot of important questions that need to be brought to the forefront of our healthcare discussions today. Rather than emphasize the implementation of a radical new policy (universal healthcare), our talking points should be centered around what can be done to improve and revitalize the system we already have in place, without putting the burden and cost of those reforms on the American taxpayer. "The Cost Conundrum" highlights the shortcomings in our healthcare system as it exists today by illustrating how common citizens, even in small rural towns such as McAllen, can be taken advantage of by doctors more interested in their bottom lines than cost-effective and quality care for their patients. This isn't to suggest that those doctors aren't entitled to those revenues, however, as the article and blogger properly suggest, measures should be taken to stress accountability and cooperation.
Perhaps, however, the root of this "conundrum" endures not because of doctors and providers, but rather because of the harsh reality that Americans are simply not knowledgeable enough about their healthcare. They focus on their frustrations (costs) without understanding why these expenses occur in the first place. It is only natural then (though admittedly by no means moral) that in some cases physicians would capitalize on this ignorance.
It is critical, in my opinion, that forums such as this site continue to educate the younger generations who have both the most to gain and lose in the coming years. As we approach this landmark crossroads under the current administration, it is my hope that an articulate and well-informed Gen Y will lead the charge in reforming our healthcare system through a means that is cost-effective, efficient, and true to our democratic values.
changehealthcare1
Well said! If the younger generation doesn't become better informed and lead the charge in reforming our healthcare system, the system will be destined for failure. It's our future at stake.