From: "ct" <email@example.com>
Subject: Re: The healthcare thread
Date: Sun, 30 Sep 2001 08:57:57 -0700
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From: "Brian Phillips" <firstname.lastname@example.org>
> #6. It takes control away from physician providers. If
> I'm an admin type I want as little "God-complex" as
> possible for my MDs and DOs. This makes it easier
> to turn the screws on THEIR paychecks next year.
> simply put, anything that can be used to lower costs
> will be.
> And that's how it works in the real world,
> cosmos help us.
In my experience, both administrators and health-care providers are
constrained by unpredictable government and market forces. Or perhaps it is
the lack of tools that can correctly predict the short-term direction of
But then, who wouldn't benefit from a vehicle that could correctly predict
Anyway, current business models chant: "profit, profit, profit". And so
it was that I extrapolated from a laboratory marketing model that emphasized
disposables to a biotech era that emphasized drugs as opposed to cures as a
way of maintaining a paying clientele ad infinitum.
Now I need to backstep and rethink my assumptions in light of the article
that seems to indicate that hospital costs are once again increasing at a
higher rate than reimbursements for drugs.
[Hospitals drive health costs. Demand for services now spurs medical
inflation more than prescription drugs]
And one must factor in the increasing reluctance of medical facilities to
render second opinions to individuals who have been given a diagnosis with a
poor outcome. High utilization of expensive testing and procedures by this
transient population does not improve the bottom line. If you can't recoup
your costs plus a slim margin, then why provide the service? Hospitals have
been driven to move away from the category of a "care-giving business" to a
business whose goal is to provide medically indicated care that maximizes
outcome for minimal expenditures.
So. Medicine no longer gives added intrinsic value to the economic equations
because one of the variables is human. Like most things in the present
climate...nothing else matters, if you don't survive the current conditions.
There is a prepublication summary of a book that looks insightful in
providing some guidance in this area:
As the Future Catches You: How Genomics and Other Forces Are Changing Your
Life, Work, Health, and Wealth
By Juan Enriquez
...Juan Enriquez puts you face to face with a series of
unprecedented political, ethical, economic, and financial issues,
dramatically demonstrating the cascading impact of the genetic, digital, and
knowledge revolutions on your life. Genetics will be the dominant language
of this century. Those who can "speak it" will acquire direct and deliberate
control over all forms of life. But most countries and individuals remain
illiterate in what is rapidly becoming the greatest single driver of the
Wealth will be more concentrated and those with knowledge to sell-both
countries and individuals-will be the winners.
It seems that disparities across many parameters within First World
countries will increase...as will disparities between First and Third World
countries. So, it was encouraging to read the Wired article discussing
ATMs to Automated Doctor Machines
(First World application):
Members of Duke University's health plan and the Oregon-based PeaceHealth
system can review and update their medical records, make appointments, renew
prescriptions and -- in the latter program -- communicate with their doctors
over the Net.
As Mary Jo Deering, director of the U.S. Department of Health and Human
Services' Telehealth program said, "A screenside manner is just as important
as a bedside manner. We need to emphasize that it's not just information
people are looking for -- but a variety of connections that would link them
to their providers."
(Third World application):
So in the Eastern Cape region of South Africa, for instance, there are 83
health care facilities with X-ray equipment -- but no radiologists.
"The potential for teleradiology there is huge," he said.
In fact, using only digital cameras, Photoshop and an e-mail program, Fraser
has helped set up a system where South African doctors can effectively
access the medical advice they need to get the information they need from
their patients' X-rays.
These technologies have applications that fill the separate needs of these
diverse economies. And at the same time, they provide applications that
optimize and unify. A good sign indeed.
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