Delivering Health Care to the People

US Health Care Spending

Whose health does the "health care" industry care about when they spend $1.4 million per day in an effort to block health-care reform? Obviously, it's not the health of American citizens. The "health care" industry is now the "profit care" industry as the pursuit of profit has totally replaced the pursuit of optimum health.

So, how do we get our health care system back? A health care system that places the needs of people before profits. How do we transform the inefficient, wasteful, fragmented health care structure we have today? That does not deliver value - defined as patient health outcomes per dollar spent - to the patient, only to the corporation.

Well, according to Harvard Business School professor, Michael Porter, author of Redefining Health Care: Creating Value-Based Competition on Results and founding member and member of the Executive Committee of the Council on Competitiveness, and The Institute for Strategy and Competitiveness.

Porter believes significant improvement in value to the patient requires fundamental restructuring of our health care delivery system. In order to achieve this, it's not enough to track only patient survival rates, health care outcomes must be measured as well, including: degree of patient recovery, length of recovery process, side effects, complications, relapse, sustainability, etc. In other words, data and result measurements must be created that allow for good decisions and which motivates and informs the provider community so that the quality of health care continuously improves.

The nature of competition in the insurance industry, as it is, destroys value to the patient by encouraging the exclusion of sick people, beating up on doctors and forcing down reimbursement so that physicians must cut the time spent with their patients

"While competition can be a powerful force that results in creation of value, this has not been the case in health care. In health care, an organization can have financial success without creating value for patients. This is because the type of competition that has existed— zero-sum "bad" competition—is not aligned with value. Competition has focused on shifting costs, increasing bargaining power, and restricting patient choice and services."

The inefficient piecemeal system we currently have must be replaced with an integrated structure that coordinates and streamlines care which will result in better outcomes at lower cost.

Three organizations must be created to oversee this type of health care system :

1. Coordinate the outcome measurement process.
2. Sort out electronic medical records.
3. Sort out reimbursements.

How Physicians Can Change the Future of Health Care

Redefining Competition in Health Care

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The Real Cost of Going to War with Iraq

The Bush Administration carefully choreographed the most elaborate display of political smoke and mirrors ever created to spare us all any "hardship". They were fully aware of how important keeping the masses comfortable was to their agenda. Sound bytes of our robust economy; tax cuts for the wealthy; displays of fake patriotism, etc manipulate, indoctrinate, and distract us away from this war as if it's not even real. Not to mention, this war is the first war financed primarily by debt held by the emerging world or simply China...that fact alone should make us a little nervous.

According to Harvard economist, Linda Bilmes, who testified before the US House of Representatives Committee on the "The Growing Budgetary Costs of the Iraq War", this war is all too real and we will be feeling the repercussions for a very long time.

We have already spent approximately $600 billion, which will be tacked on to the continued operating costs of this bloody war. After the war, the cost of reset, or restoring the armed forces to Pre-Iraq level of readiness and equipment will be enormous and let's not forget interest payments on the money we borrowed to finance the war.

Subsequently, money, already promised to take care of veterans and their families will have to be paid out. Already, 263,000 veterans from Iraq and Afghanistan have been treated for medical disabilities in the Veterans Health Administration. An additional 50,000 soldiers have come home with PTSD and one-third of those affected will not be able to work at all. The cost alone will be between $300 -400 billion dollars.

The Iraq war presents new challenges never seen before as there are so many more soldiers surviving making the cost much greater. Approximately 2.5 soldiers were wounded for every soldier killed in Vietnam and Korea. Today, there are eight soldiers wounded in combat for every soldier killed, and accounting for the full range of injuries and diseases, there are 15 or 16 wounded soldiers for every one fatality.

Chief neurosurgeon, Dr. Gene Bolles, in his thirty years of military service, has never seen injuries as severe as he has seen come back from Iraq. Over the long term, caring for these soldiers will be astronomical.

In the first gulf war, 700,000 US soldiers fought and 44% of them claimed disability compensation. We now spend approximately $4 billion on Gulf War Vets. Imagine if 44% of the soldiers fighting the current war claim disability compensation, not to mention our fragile social security system will have to pay disability compensation in addition to Veteran benefits.

Value of Statistical Life (VSL)is the estimated lost productivity or economic output of a life. Currently, insurance companies estimate the value of a statistical life at $7 million. The military estimates the value of a statistical life at $500,000, which is paid out to families of soldiers killed in war. 4,000 soldiers have been killed thus far, a $30 billion dollar economic loss. It is also estimated that one in five families have to sacrifice to take care of a disabled veteran now. That number will only increase.

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