With all the
highfalutin talk about the Triple Aim, payment reform, ACOs, population management, and the like, wouldn't it be nice if hospital administrative and clinical leaders focused on these categories of harm that have been identified by the patients and families who have experienced a medical error.* Instead, our "leaders" and their governing bodies focus on building their networks to gain market power and minimize competition, expanding their risk pool, minimizing corporate risk, and fighting over who should share the surplus or deficit from capitated contracts. They are truly cost centers in search of revenue streams. This is the corporatization of American health care.
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*Yes, these are Massachusetts numbers, but they are duplicated in other jurisdictions.
The worst part of it is that most of them are 'nonprofits.' This designation should be seriously rethought - their tax revenue could be of significant benefit to taxpayers in the localities in which they make money off their patients while harming them.
ReplyDeleteShocking numbers. I agree that we have a warped system and as a result much of our health care spending dollars is (mis)directed to administrators and non-clinical players of the "medical industrial complex," as this NYT article illustrates:
ReplyDeletehttp://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=0
I really admire and enjoy your perspective. I'd love to hear your suggestions for the MBTA!
ReplyDeletenonlocal MD has it right. I've been asking my state legislators and the federal legislators that. I've sent letters to the local "monopoly" and asked. I'm going to keep asking. Their silence is what advertises to more people.
ReplyDeleteIn addition, the civil rights loss, the lack of due process, and the attitude from state agencies and medical boards is sickening. I FOIA'ed their medical resources and they reported they have nothing for that. Really? So your mission is to protect the public but you don't have the resources to do that? You think a nurse can outguess a doctor? The conflicts of interest between them and the lobbyists is incredible. We had a group of lobbyists come up and visit the state medical board. All when $$$$ would go to their pockets if their legislation is approved, and if they don't, they will sue the state (meaning taxpayers pick up the burden).
I suggested on the WBUR Blog earlier this year, on the occasion of the rededication of the Betsy Lehman Center, that all Massachusetts hospitals publicly adopt a "zero preventable errors" goal and also commit themselves to transparency. I noted that the former vow had led to demonstrably significant numbers of lives saved by St. Louis-based Ascension Health more than a decade before and that Louisville-based Norton Health had been far more transparent than anyone in Massachusetts -- in both cases, for more than a decade.
ReplyDeleteBut, of course, many in Boston would rather boast of their academic accomplishments and burnish their reputations than face accountability for preventable deaths caused by treatment.
Bravo, Paul!