All you hear about currently is the Australian “health debate” a debate the pollies have decided to have as a political exercise, are discussions about who gets to spend the money i.e. exercise the power, it has little to do with the health outcomes of Australians, that is just the excuse.
Cynical perhaps, but if it were otherwise, you would be hearing real discussions about the manner in which the billions were spent, not how just much, and by whom. We do need more to be spent, but more importantly in a society where health costs are increasing rapidly, and will continue to do so, we need debate, and importantly action, on the effectiveness of the spending, and the means by which that effectiveness, measured by patient outcomes, can be improved.
Applying proven process improvement, Lean, and Six Sigma commercial disciplines to public spending should be a priority, but perhaps that would impinge on vested interests a bit much, so we leave it alone.
The parody via the “Lean” hyperlink above has a scary resonance, and we leave discussion about the effectiveness of spending alone, to the great cost of to our community over the medium & long term.
Mark,
Seems like we all face the same problems.
From a distance I have watched the politics around the health care bill put to Congress by Obama, and was astonished at the venom of the opposition.
How could any so called civilised society exclude so many of their fellow citizens from care. OK, the cost is substantial, but the cost of not doing anything is far greater, just hader to quantify.
I can’t speak for Australia, but the things here in the USA that scare me the most are:
– The patient is used to transmit critical information from one practitioner to another. It is up to me to tell the specialist why I am being referred, and often up to me to relay details of his conclusions back. The bandwidth of the doctor-doctor communications system is limited to a few lines.
– The opportunities for error that each care giver faces in the course of a routine workday are staggering. The system relies on hyper-vigilance of individuals to catch and correct this errors before they harm the patient. The few that slip through the screen end up killing twice as many people as automobile accidents. Put another way, Steven Spear observes that, hour-by-hour, a Marine on street patrol in Fallugah in 2005 was safer than you are in a hospital. Scary stuff.
– The mind-numbing processes, like the ones on the video, that everyone takes for granted as the way it has to be.
I wish I remembered where I heard it, but one estimate was that by taking care of #2 above alone (systematically reducing opportunities for clinical error), the U.S. system could easily pay for itself, at less than current funding levels, and cover everyone.
But, no. As you point out, the debate is in how to control CHARGES, not control COSTS, and about who will pay, not what we will pay for.
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