The Strange World of Healthcare

Commentator Paul Harvey once illustrated how complicated and bizarre the world of healthcare is by using the metaphor of your local grocery store:  "What if your grocery store had to operate under a system similar to how hospitals operate?" 

Imagine:

1.  Before you go shopping, you would have to enlist the help of an "expert" to determine what groceries were needed.
2. Before going to the store, you'd have to contact your "managed grocery store provider" to request permission to go to the store.  They would check and see how many times you've been recently, whether the visit was reasonable & customary, and select a "preferred grocery store" in their "network"...even if that store was in the next town over.
3. Once at the store, the "advanced practice grocer" would review your shopping list.  She'd also have to access your personal "grocery record" to assess what groceries you'd bought in the past and determine what groceries were allowed by your plan.  Generics preferred.
4. Your grocery record, by the way, would contain a list of every grocery you ever bought, what it was used for, and whether there were any negative outcomes or led to additional shopping
5. You would then make your way to the "grocery payment clerk" who would total up your groceries.  The total cost of your groceries?  $250.  Your bill?  $1,250.  Why??  Because you have to make up the shortfall caused by the last two shoppers who were on government plans that don't pay the actual cost of their groceries so someone has to make up the difference and that would be YOU.  The industry calls that "grocery cost shifting."
6. By the way, your local grocer is thinking hard about giving up groceries altogether and getting into the bar business because the red tape is driving is costs higher every year just as his reimbursement keeps getting cut.

We are, indeed, in the strange world of healthcare.  What other business can you think of in which the consumer doesn't pay for the goods & services, a 3rd party (ie, insurers or government) does?  Or a business where the major decision makers in the organization--in this case doctors -- aren't employed by the organization or, for that matter, held accountable by the organization?  Or a business increasing focused on "customer satisfaction" in which the very services we provide often cause "customer dissatisfaction"...the post-surgical pain, the painful rehabilitation following knee-surgery, blood draws, vital signs taken in the middle of the night?

...and all of this done in an industry that is the most highly regulated in the world...more highly regulated than Wall Street, the space program, or the banking industry. 

Is it little wonder that we have trouble sleeping at night?

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