Wednesday, March 13, 2013

Online Health Care Innovation Forum:   “Alternative," Another Word for “Innovation"

What’s the alternative?

Question asked by thoughtful innovators

So that the record of history is absolutely crystal clear. That there is no alternative way, so far discovered, of improving the lot of the ordinary people that can hold a candle to the productive activities that are unleashed by a free enterprise system.
Milton Friedman (1912-2006),  Conservative American Economist 

I ran across the following  article in the  March 11 Charlotte Observer “Lawmakers: Surgery Centers Would Provide Alternative to High Hospital Bills.”  T

Three GOP lawmakers introduced it.   The  North Carolina hospital association, which last year gave more than $1 million to political candidates,  opposes it,  saying it would benefit a handful of doctors.  The state employees association is for it.  Its spokesman  says,” Lawmakers have a chance to give citizens relief from extraordinarily over-inflated hospital prices. It’s ridiculous if they don’t take that opportunity.” North Carolina’s gastroenterologists and orthopedists, both of whom often perform outpatient surgical procedures,  support  it.
So it predictably goes.  For some things, like whether to live or die, there is no alternative.  But when it comes to surgical procedures or where to get nonsurgical medical  care-  in  hospitals,  doctors’ offices, facilities owned by both,  or in patients’ homes,  there are alternatives. 

To borrow a phrase from the real estate and business world,  “It’s location, location, location!” Or,  in monetary terms, “It’s money, money, money!”

In political context,  if one reads the budgets just put out by Paul Ryan (R, Wisconsin) and Patty Murray,  Democratic Senator from Washington State,  “It’s control, control, control!” The government or the free-enterprise system are the alternatives.  
Regardless of who wins this high-stakes budget contest,   keep this in mind.   For every failure, in this case, out-of-control hospital costs, there’s always an alternative.  We need to find it.  And if the road special interests block the road, either politicians or bureaucrats, take a detour.
As the article points out,  “Medicare, Medicaid and commercial insurance all typically reimburse ambulatory surgery centers at substantially lower rates than hospitals. Medicare, for instance, pays hospitals an average of more than $1,300 for each carpal tunnel surgery – about 73 percent more than it pays ambulatory surgery centers.” It makes sense to ambulate your way out of the hospital to a nearby ambulatory surgical center.

What’s the answer to finding the alternative location for outpatient surgery?  One answer is legislatie. Another is to  do away with hefty “facility fees."   Another nother is to examine, standardize and streamline those hospital chargemaster accounts. They  charge ridiculously high fees for mundane  things like aspirin or cotton balls, as highlighted in Steven Brill’s 24, 000 word expose in the February 20, 2013 edition of Time magazine.
However you slice it.  There is an innovative alternative.  Let’s find it.

Tweet: In N.C., lawmakers have introduced a bill clearing the road so doctors can perform surgeries outside of hospitals and hospital control.


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