Lisa Simpson
Aug 7,2009
In: Finance

America has the Costliest Healthcare Infrastructure But not Matched by Equivalent Standard

Research is being carried on as to why America has the costliest healthcare infrastructure but it is not matched by equivalent standards. Among the affluent countries, Americans are among the least healthy citizens.

The best hospital in America is Mayo Clinic – it being the foremost in treatment technology. It is the prime hospital in Rochester, Minnesota. Yet Medicare spending per person in Rochester is one of the lowest in the country.

In a research conducted by Elliot Fisher a survey was made of a million elderly persons who suffered from colon or rectal malignancy, hip fracture and heart disease. In some parts of the country the patients got 60% more medical attention but they did not live long, function in a more improved way or exhibit greater satisfaction.

The most important difference between low-costing and high-costing regions was that the latter got less of low-costing deterrent services like vaccines and had to wait longer to get admission into the emergency.

McAllen County in Nevada accounts for second highest Medicare costs in the country after Miami. Here doctors frequently transferred patients to specialists. Why? The administrator of the hospital suggested that the answer to this query can be found by studying the proportion of the earnings coming from their practice. Invariably it would be found to be low. A good proportion would flow in from kickbacks from referrals.

Two things make Mayo Clinic different from the institutions of McAllen. The doctors and the specialists of Mayo Clinic are given salaries only. Their personalized services are not priced and therefore there is no possibility of their incomes being maximized. They see patients together as a matter of routine and discuss matters. In other words they are full time professionals who are tuned to work in a cooperative manner.

In Colorado doctors were paid piecemeal by insurance firms. But they had a workout and decided on a structure based on common fees that would be charged on all. They also settled to meet regularly in committees known as peer-review to go over again the records of the patients. They also signed in for a local community electronic-record scheme that brought together the notes of the patients.. This arrangement is known as the Grand Junction of Colorado.

Surgeon Atul Gawande, after having conducted research at the micro level and comparing notes with the work done at the macro level by Alan Garber and Jonathan Skinner, opined that the best answer to healthcare problems in America would be the setting up of doctor’s cooperatives.