Top Ten
Always interesting to see what people are reading or what they think is important. Notice how the economy has risen to the top of the interest scale for voters and the Iraq war has subsided a bit. Healthcare remains near the top, and it seems inevitable that any next administration will press for coverage for the uninsured. Not clear, however, how they will pay for it. Also today, a new bill to compel payment for mental health on the same basis as physical health problems. This also will increase costs with no payment mechanism in sight.
Health Affairs listed their top ten blog hits for 2007 and another list for ytd 2008.
For 2008, lots of interest in spending--historical levels and predictions. As a bonus, they also list the most read articles from the journal. One interesting article in this latter list by Wm. Savedoff talks about what a country should spend on healthcare. The complexity of the question makes interesting reading. He makes the classic error, however of linking healthcare spending to population health, as if spending more on healthcare would somehow improve health. (see previous postings here for more on that!) He does point out the widely varying expenditures in countries with similar infant mortality and even states at one point, “it is extremely difficult to attribute changes in health status to healthcare spending.”
An article on “disruptive innovation” (Clayton Christensen, see previous posting here) made the top ten. His thesis is that innovations in healthcare service will further the faster-better-cheaper cause. This is, of course, true, but unlikely to happen without some compelling reason. There are, in fact, examples of “innovations” in healthcare today that perform faster-better-cheaper. Surgery centers are familiar to me, but there are others. Hospitals, however will not emulate these processes, primarily because they get paid not to.
For 2007, most articles on the list focused on healthcare reform, the au current topic of that era. These fell into two broad categories:
1. Central planning. Advocates of a single payer system. I seem to remember that the Russians tried central planning some years ago, and the results were not good.
2. “The world would be better if I were in charge.” This only works for the world of the person in charge--typically someone who’s never been in charge before.
Interesting that both lists have an article about the nursing shortage.
As competitive politicians promise more and more in the coming months, questions will turn more and more to how to pay for more and more.
Health Affairs listed their top ten blog hits for 2007 and another list for ytd 2008.
For 2008, lots of interest in spending--historical levels and predictions. As a bonus, they also list the most read articles from the journal. One interesting article in this latter list by Wm. Savedoff talks about what a country should spend on healthcare. The complexity of the question makes interesting reading. He makes the classic error, however of linking healthcare spending to population health, as if spending more on healthcare would somehow improve health. (see previous postings here for more on that!) He does point out the widely varying expenditures in countries with similar infant mortality and even states at one point, “it is extremely difficult to attribute changes in health status to healthcare spending.”
An article on “disruptive innovation” (Clayton Christensen, see previous posting here) made the top ten. His thesis is that innovations in healthcare service will further the faster-better-cheaper cause. This is, of course, true, but unlikely to happen without some compelling reason. There are, in fact, examples of “innovations” in healthcare today that perform faster-better-cheaper. Surgery centers are familiar to me, but there are others. Hospitals, however will not emulate these processes, primarily because they get paid not to.
For 2007, most articles on the list focused on healthcare reform, the au current topic of that era. These fell into two broad categories:
1. Central planning. Advocates of a single payer system. I seem to remember that the Russians tried central planning some years ago, and the results were not good.
2. “The world would be better if I were in charge.” This only works for the world of the person in charge--typically someone who’s never been in charge before.
Interesting that both lists have an article about the nursing shortage.
As competitive politicians promise more and more in the coming months, questions will turn more and more to how to pay for more and more.
