A number of years ago, one of my brothers had a kidney stone. He was admitted to our local community hospital. Since this was pre-lithotripter days, the treatment options were limited. My mother wanted my brother moved to a world-renown teaching hospital in
The Boston Globe ran an article yesterday discussing how some of the nation’s top ranked hospitals have been able to negotiate fees that are much higher than other hospitals and achieved higher profit margins. The question, of course, is whether the additional cost is justified for most patients?
The fantasy has always been that patients will somehow be placed in the facility that can best care for them at the lowest cost, while achieving the same outcome and quality. Nice theory – but patients often don’t fit into the neat boxes as their condition may change. Hauling patients around is often not a great idea.
The questions raised in the article are worth exploring and questions to be conscious of. That said, as we look to tackling health coverage in the coming Obama administration, getting a handle on how we will train future and current physicians, conduct research, and provide the leading edge care is a critical issue that cannot be pushed aside in the rush to expand coverage and control costs. Physicians should be front and center in the public debate on how we will measure the value of what physicians do. Measure we will. It’s how, and where we, as a nation, put our dollars.