Why our health care costs so much

Ezra posts a fascinating long read today about an experimental health care program that saves money. It's based on a simple concept that doesn't require costly medical equipment. It basically consists of regular home visits to housebound elderly patients by registered nurses. It kept these patients who suffered from chronic but easily treatable conditions from ending up in hospitals. Apparently it worked too well.

But Health Quality Partners, with its emphasis on continuous nurse-to-patient contact, did work. Of the 15 programs, four improved patient outcomes without increasing costs. Only HQP improved patient outcomes while cutting costs. So Medicare extended it again and again — now it’s the only program still running under the demo. But Medicare has notified Coburn that it intends to end HQP’s funding in June.

Medicare mumbled something about the program not being scalable, which isn't really true. The real reason comes down to corporate control over our health care system.

But not all hospitals are run by the local Village Improvement Association. Many seek to turn a profit. That makes models like Health Quality Partners something of a threat. “If we scaled what Ken is doing,” Brenner says, “you would probably shut down a third of the hospitals in the country. It’s a disruptive innovation. It just guts the current business model.”

See also this:



And this:



The HQP program was only allowed to succeed because it was being sponsored by a group who weren't interested in profits. Meanwhile the industry trend is to ever greater consolidation under larger corporate umbrellas. They spend millions on lobbyists to ensure their business model endures in order to protect their bottom line. This is how we ended up with the Rube Goldberg reform bill we now call Obamacare even though an expansion of Medicare would have been much more cost efficient.

The clear lesson here is, for profit, corporate health care is neither about health or care. Not sure how it's possible considering the breadth and strength of the lobby that protects it but the only way to truly fix it is to take out the profiteering altogether.