The Iron Healthcare Triangle
Why America’s Healthcare is F*#!ed
Professor Regina Herzlinger has been studying the U.S. health care system for decades, advocating for consumer-driven reform as the best remedy. But the slow pace of change, which she attributes to a fat-cat network of insurers, policymakers, hospitals, and even employers, has her fed up. Her new book, Who Killed Health Care? adopts the emotional language of a manifesto in demanding change to make health care more responsive to customers, affordable to those in need, and a hotbed of innovation and entrepreneurship. Key concepts include:
- Today’s American health care system is set up structurally to reward the major players—hospitals, health insurers, and lawmakers—while short-changing patients and taxpayers. Hospitals want to control the health care delivery system, and they’ve become oligopolists or monopolists in many markets, thus obviating price and quality competition, and they’ve become vertically integrated by hiring physicians and using them. Initially the hospital was a place almost like a hotel or an office while the doctors were the stars. Increasingly, the hospitals have won the power struggle, and the physicians are more or less the blue-collar workers. Whether Democrat or Republican, power is seductive, and politicians are actually practicing medicine … by micromanaging the payment system.
- Health care is not the hotbed of innovation and entrepreneurial activity one might expect from a $2 trillion industry. Risk takers are often beaten down by established interests.
- 300,000 people die every 3 years in hospitals. How? Through uncaring bureaucracies, over-stressed care providers, and poor management. In a hospital, the scope of work is so broad that the possibility of cross-infection is monumental. If you go into a general hospital, there’s no way they can keep those walls and floors clean and free from all bacteria. Another reason is “failure to rescue.” If something happened to you, your respiration got compromised, you couldn’t breathe, and they didn’t get to you in time.
