Healthcare: cost cuts

In his White Paper Grossman makes two suggestions. (1) Control of one s care should be returned to the doctor and patient that is essentially basic personalized medicine. (2) Every HMO should offer healthcare plans and prices for the consumer to choose from that is in accord with bringing the healthcare system into the twenty-first century with information technology. Although healthcare industry has been slow to catch on, IT applications are expected to cut costs and improve efficiency by automating workflows for clinical practice as well as financial management. 

From this, two facts emerge. First, it is not the best use of its time for a health service to focus on cutting expenditure on the drugs budget, since this is a tiny proportion of the cost. Second, it is inappropriate for the pharma-company to seek to increase market share in such a tiny market. Pharma-companies would do better to find ways of participating in the wider aspects of healthcare delivery— because that is where the money is DM, with its multifaceted and comprehensive approach, provides that vehicle. 

A more important and contentious issue relates to the standardization of clinical practice itself, in the form of guidelines, protocols, decision support and structuring of tasks and procedures. Clinicians are sometime suspicious of these initiatives, suspecting that standardization is being imposed not to improve healthcare but in order to regulate, cut costs and otherwise constrain clinicians in their work. However, properly understood and implemented, such approaches are potentially a support to the clinical staff. Standardization and simplification of core processes should reduce the cognitive load on clinical staff - thus freeing them for more important clinical tasks that require human empathy and expertise. 

Fragmented healthcare delivery promotes wasted time, efforts, materials, medications, money, and trust. The term efficiency is often mistaken for cutting comers. There are two primary methods to increase the efficiency of the healthcare systan. The first deals with reducing waste at aU levels, and the second addresses lowering administrative and production costs. Healthcare must uever reduce and/or eliminate services based on a patient s race, ethnicity, or gender. Patients must receive treatment on the basis of need and not on personal characteristics unrelated to their illness. While patients may vary in their desire to be involved in their healthcare, often, they feel excluded from discussions and decisions that affect them. As a consequence, patients may find their healthcare to be not only impersonal, but they are often left confused and unsure as to what they need to do in regard to participation in their care. 

---