AV’s recent inpatient surgery experience – she had a cervical dystectomy (relatively common neck surgery) – reminded of how fundamentally flawed our US healthcare system is. Almost every industry/market that’s “efficient” functions on some basic common principles/dynamics: Customers make purchasing decisions based on cost, quality and service and producers/companies compete on the basis of these 3 core product/service “differentiation” dimensions.
Let’s take the retail industry as an example. Walmart is all about being low cost and has build a business model that continuously wrings cost out of the entire supply chain for the goods they sell. A store like Nordstrom on the other hand tries to be more upscale, so it competes on service and to a lesser extent quality (by carrying brands perceived to be higher quality). And Louis Vitton, Tiffany, and other luxury brands compete largely on quality only (with quality being defined as a combination of style/perception, brand value, material, cut, etc.).
The key to the above tradeoffs occuring, of course, is information (transparency) about the 3 differentiating dimensions, particularly quality and cost….to enable consumers to evaluate different companies and make their decision based on what matters most to them. But none of this is possible in healthcare – an industry that is almost a fifth of US GDP!
In healthcare, you make a decision with no idea of what it will cost you and really no way/system of getting such a cost estimate without significant effort. And quality is an entirely different matter. Where cost is difficult but not impossible to assess, quality is. There is absolutely no data available to consumers to help them understand the experience level and output/performance (aka “outcomes” in healthcare) of the doctor they choose to go with. And did I mention there’s no systematic way of finding a doctor that meets your needs? The whole system of finding a doctor is primitive – you ask around to see if anyone you know (including other doctors one might know) have a recommendation (which is again, largely based on perception/reputation and not facts).
I am definitely a believer that government led investment in infrastucture is a key tool to help get the US out of the current economic crisis (while making sensible investments which will pay off and are required for our long term health). I would love to see the Obama administration address some of the issues above to help get the US healthcare industry more nimble, competitive and no doubt efficient.
