Saturday, November 17, 2012

Saving by Spending

As I think I have mentioned before, I came to realize early in my career that everything I did to improve efficiency in the hospital cost more money. Managers and doctors would justify things they wanted to do on the grounds that they would reduce cost, but when it came time to implement them, they seemed always to require a budget increase somewhere without an offsetting decrease somewhere else. 

Apparently, things haven’t changed all that much.  According to an article in the November 12 issue of the Omaha World Herald, (copied from the Raleigh, NC News and Observer), “….the federal government is offering as much as $22.5 billion in incentives for adopting computerized patient records – up to $63,750 per doctor.”   

All of this, of course, is an attempt to make the provision of health care more efficient by spending more money. 

After a few such experiences, I concluded that we in health care were going about it in the wrong way.  We were trying to improve things without disturbing the underlying culture and basic structure of the health care establishment and there doesn’t seem to be any way of doing that.  There are investments that make it possible to reduce cost, but they all involve changes that affect somebody adversely. 

It’s a truth we still haven’t accepted in health care and so we continue to think we can reduce cost by spending money.



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