Paul Grundy MD, of IBM, chair of PCPCC, is interviewed in the current Crain’s Benefits Outlook, a business publication about employee benefit programs. This quote alone is worth the price of admission:
I can buy a damn good amputation for my diabetic, but what I can’t get is a good system in place to prevent my diabetic from needing the amputation. We don’t reward a system in which comprehensive coordinated care and robust prevention is valued.
Amen. What are we thinking, insurers, when we fund treatments instead of preventing them??
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But things will probably change very soon. The latest nominee to the Obama administration, Peter R. Orszag, is probably a very important addition. Nominated to head the OMB (the Administration’s Office of Management and Budget) he has been head of the equivalent CBO (Congressional Budget Office) for the last 2 years. He has written extensively about the fiscal issues of the American healthcare system and has lately played close attention to behavioral economics, as a way to change the national picture. This nomination shows that the Obama administration will indeed be very active in the necessary deep reform of the healthcare system.
Amen! I hope the Obama administration also considers re-educating the American public about more “preventatives,” like early warning signs of cancer and revise referral routes for suspected cancers. That is not profitable in the short run for either the insurer or the medical practice which does the referral. It only saves lives unnecessarily lost to cancer — the supposed battle cry of America’s putative “War on Cancer.”
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Re preventatives, you might want to review the exchange you and I had three weeks ago on my blog, in my last post about Best Care Anywhere:
Think about that. I’m not saying anyone designed it that way, but if we’re going to transform it, we need to understand what it really is, designed or not.
Generally, complex systems perform according to, and stabilize consistent with, various feedback loops that keep things the way they are. If it WERE a treatment-delivery industry, then over time it would tend toward delivering more treatments, and not trend toward prevention. And that’s what we see.
Prevention is one of the big things the VA healthcare system was getting really good at. Please do take another look at that post about how the Bushies made some insane decisions, which I hope Obama’s team will restore.
And remember, Best Care was written by a pro-markets guy, Phil Longman. The last thing he expected to find was that the best healthcare anywhere would be found in a socialized system. But that’s what he found, and he reported it.
I’m no expert about diabetes but a diabetic friend recently taught me about CGM (continous glucose monitoring). He’s now using a CGM device, the Freestyle Navigator, and he says it’s “life-changing.”
This quick animation on their site instantly makes the point about how useless it is to check once every few hours.
I can see how that would be life-changing: all I have to do is imagine if my leftover tumors might be ranging way up and down in their activity all day and night, and if I didn’t catch them, I’d be screwed.
This podcast about CGM makes the same point. It’s from Manny Hernandez of TuDiabetes.com:
Again, what are we thinking, if we fund treatments instead of preventing them? Are we really a treatment-delivery industry instead of a health-seeking industry?