Tag Archives: quality of care

Global Competitiveness

“We all have a stake in improving the quality of care we receive while spending our dollars more wisely,”

“It’s good for businesses, for our middle class, and for our country’s global competitiveness.”

HHS Secretary Sylvia Burwell

For anyone who believes that I have been out of line in linking the national obsession by health care pundits, economists, and managed care apologists to destroy fee for service medicine in the name of enhancing America’s global competitiveness, you just have to read a recent observation linking the two by our current HHS Secretary.

The link was buried in a story reported by The Hill and others about savings from the nation’s Accountable Care Organizations (ACOs). http://thehill.com/policy/healthcare/217881-small-savings-reported-from-new-healthcare-models

Only about half of the ACOs that reported their financials had savings. See Jordan Rau’s excellent report on this complicated topic for Kaiser Heath


I am mystified about how ACOs enhance our “global competitiveness.” But that’s what happens when you just have medical and law degrees but not an MBA or a PhD in economics from a prestigious Ivy League University.

Does it mean we will use the savings to build more prisons? We already lead the world in the number of our citizens – now disenfranchised from voting – we have in prison. And the private prison owners/political donors are laughing all the way to the bank.  Or maybe we can pay for more re-cycling of closed prisons as immigration – er future voter – living quarters?  Isn’t it ironic that we put our citizens in prison and they lose the right to vote, but when immigrants are put in the re-cycled prisons, they are way stations on the path to vote?    Again, I don’t have a degree in criminal justice or political science so I can’t understand the process.

Will we have more money for higher salaries for professional athletes under indictment for domestic violence and child abuse? We already lead the world in that.  Young doctors should be proud that our average professional baseball player makes well over $1 million per year, and an unnecessary test ordering pediatrician gets an exorbitant $120k or so.

Will it increase the amount of money we have to spend on pets – who are considered members of the family? I think we lead the world on that, too.

Will it increase the amount of money we have to spend on golf? We have been pretty bad at Ryder Cup play in recent years and sure need a boost there?

Maybe it will help us wage better wars (err counter terrorism efforts) in foreign lands? We lead he world in that too, but never have enough money to spend on foreign adventures to prop up defense contractors and other big political donors. See owners of private prisons above.

Or maybe we can give some subsidies to GE so it can sell more CT scanner in China.  I hear doctors there like to use them to order unnecessary tests to enhance income – at least according to the Wall Street Journal.      

Maybe we can build more Chrysler and GM and Ford cars? After all, they deserve the same tax incentives that Tesla got in Nevada. And the “Big Three” auto makers are always interested in telling doctors how to compete even though they can’t figure out how to build cars that can compete with their South Korean, Japanese, and German rivals.

And I’ll pose the eternal Uwe Reinhardt question that never gets answered: “Why is it good when Americans buy cars, but bad when they buy health care?”

What’s very clear is that in the not –too- distant future ordering unnecessary care for some dying senior with heart failure will be viewed as a felony punishable by prison time because the doctor who ordered it placed that individual’s selfish will to live over promoting America’s global competitiveness –whatever that is.   He wasn’t a good team player and the taxpayers need to finance his prison stay to help preserve our country’s global competitiveness.

Here’s my last question: What happens when we get rid of fee-for-service medical payments and everyone is in managed care with fixed contribution payments?  How do we enhance our global competitiveness? Maybe start HMOs and walk in clinics on Mars?