Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker

Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker.

I went to a conference this weekend and one of the talks revolved around the financial aspect of health care and health care reform.  This article was brought up again and again.  It’s a fascinating read.  One telling aspect is that higher cost does not always equal higher quality.  It butts up against the entitlement mentality of America and is in part of the reason health care is so expensive.  Free does = more.  Sad.



  1. Your last comment about free = more and the entitlement attitude is puzzling to me. After all the ones receiving the free medical coverage entitlement benefit are not the problem, according to the author. The higher costs are driven by profit seeking doctors, from the author’s point of view. He asserts that the entreprenurial spirit of the doctors conflicts with providing the best for the needs of the patient, which also lowers actual quality of care.


    1. Free=more wasn’t a direct response to the article itself, more a general comment that happened to be dropped into the conversation.


  2. Yes, the cost variation in U.S. medicine is incredible.

    The “secret Key” is to align the financial incentives of the physicians (who drive over 80% of patient care & testing costs) with insurers (who process bills – they more bills they process, the more they profit) with hospitals (who have huge fixed costs, so like a hotel, an empty bed makes $0 contribution to overhead costs), with manufacturers (who make increased profit with single use “disposables”).

    Fully functional EHR/EMR will be a powerful tool to align cost and outcome data to shift the model to reimburse for efficient, quality healthcare. When a High Intensity Workforce Team of caregivers is provided real-time, accurate patient and cost data, I have seen ASTOUNDING results.

    The rapidly developing Hospitalist model of care will also be very powerful once they begin to implement P4P and hospitals implement EHR.


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