Jul 6, 2009

Setting Audacious Goals

Hello young improvers!

I'm a long time reader but first time poster to the blog. I came across a great article in this morning's New York Times Op-Ed section that I thought many of us would be interested in. It's a piece written by Paul O'Neill, the former Treasury Secretary turned health care improvement crusader.

In his piece today, O'Neill writes about how, thus far, the goals Washington has set for health care reform have not been "audacious" enough. He states that there is about $1 trillion of annual waste in the health care system and that's what we need to tackle, not the miniscule cost inflation reductions that Obama has wrangled out of the insurance companies. He offers that one great place to start is nosocomial infection reduction, and he points to some star health care improvement leaders -- Gary Kaplan, Brent James, Rick Shannon -- to give us shining examples of what's possible.

Best of all, O'Neill says that the system needs more improvement-minded leaders. That's us guys!

Hope you can check out the article. It's a good read.

- Alexi (Yale Med 2010)

1 comment:

Anonymous said...

From the article:

"What policymakers tend to forget is that only the people who do the work can make this happen. Legislation can’t do it, regulation can’t do it, infection-control committees can’t do it, financial incentives and disincentives can’t do it."

Uh, so why are you telling Obama to make it happen if it's not possible for government to make it happen?

At any rate, I don't see how legislation couldn't do it. Just pass a law saying that any hospital that doesn't meet or beat a limit on hospital infections will be heavily fined or closed down.

Later on O'Neill says:

"A next step would be for the government to finance a prompt, detailed and hard-headed study of every example of error, infection and other waste in five major medical centers."

I'm a little confused. Can government solve this or not? Do we need an "infection-control committee" or not? It seems like such a committee would be exactly what is needed to undertake the very kind of study O'Neill suggests.

O'Neill seems to be attempting to disagree for the sake of disagreement, but he's not doing a very good job. Mostly he's just disagreeing with himself.

And in any case, O'Neill's reform does nothing to make healthcare more affordable for those who can't afford it now, which is one of the principle goals of healthcare reformers.

Obviously if there is both cost savings and improved medical outcomes to be realized by reducing the harmful side effects of hospitalization, we should do it. That doesn't mean the other aspects of healthcare reform aren't important. A cancer patient without health insurance doesn't care what the hospital infection rate is if he can't afford to get treatment in the first place.