Tuesday, September 26, 2006
US Healthcare
System in Crisis
Have been travelling in the US the last few days. Right now am in my hotel room in Boston, on the banks of the Charles River, and right across from where I am is the Mass.General Hospital, one of America's best ranked Hospitals. Everytime I go there, the feeling is overwhelming, and I wonder when one of our institutions will grow to that stature.
But what beats me, is that despite having a large number of world class facilities, the overall healthcare system seems to be in crisis. Almost everyday, the newspapers have some story about the spiralling costs of healthcare, the growing numbers of the unisured, and the problems the baby boomers are expected to face. And the more I read these, the more convinced I am that Indian Healthcare entrepreneurs can demonstrate interesting models that can help the US healthcare system come out of the hole it is in right now.
Have been travelling in the US the last few days. Right now am in my hotel room in Boston, on the banks of the Charles River, and right across from where I am is the Mass.General Hospital, one of America's best ranked Hospitals. Everytime I go there, the feeling is overwhelming, and I wonder when one of our institutions will grow to that stature.
But what beats me, is that despite having a large number of world class facilities, the overall healthcare system seems to be in crisis. Almost everyday, the newspapers have some story about the spiralling costs of healthcare, the growing numbers of the unisured, and the problems the baby boomers are expected to face. And the more I read these, the more convinced I am that Indian Healthcare entrepreneurs can demonstrate interesting models that can help the US healthcare system come out of the hole it is in right now.
# posted by Srivathsan @ 5:09 PM 
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I think one problem with the US healthcare system may lie exactly in what you found so admirable - MGH. Healthcare systems (the world over) are hopelessly hospital centric and customer unfriendly. By the the time the MGH accountants figure out where the true costs of healthcare are in their tangled web of basic research, clinical research and actual clinical care they would have lost the energy to do something about it. About 50% of the costs in healthcare today can be taken out by simple lifestyle measures and preventive healthcare. This is simple, but what is simple is not necessarily free and we have not figured out a way to pay for it. Before admiring MGH I would rather tip my hat to Renaissance Health (also located in the Boston area) - an organization that is attempting to reinvent that most precious link the the healthcare chain - Primary Healthcare.
Thank you Swami for your observations. Primary care, especially in the manner that Renaissance Healthcare is attempting to deliver, may have the potential to take out costs from the system. It is still early to say whether we should bet all our money (or atleast a lot of it) on Primary care as the key enabler of lower costs, because it has yet to deliver empirical data in support of this. To say that 50% of healthcare costs can be taken out by simple lifestyle measures and preventive healthcare is simplistic, only because we have yet to create those incentives that will make consumers want to take charge of their own health.
You make an excellent point about the difficulties hospital accountants might face in figuring out the true costs of healthcare delivery. Not just at the MGH but at almost every healthcare system across the US (I believe that the accountants in India might be in a significantly more comfortable position, if only because third party payment systems have still not taken over).
But despite all that, the MGH is certainly an awesome institution (the day after I posted that note, I had occasion to go a vistor's tour of the facility, and discovered that it will celebrate 200 years of its existence in 2011)In these years that it has been around, it has been at the forefront of healthcare, be it treating patients or medical research or education. It is the kind of institution that any country would be proud to have, and I really hope that some of India's tertiary care hospitals (most of them are pretty recent) become like the MGH some day.
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You make an excellent point about the difficulties hospital accountants might face in figuring out the true costs of healthcare delivery. Not just at the MGH but at almost every healthcare system across the US (I believe that the accountants in India might be in a significantly more comfortable position, if only because third party payment systems have still not taken over).
But despite all that, the MGH is certainly an awesome institution (the day after I posted that note, I had occasion to go a vistor's tour of the facility, and discovered that it will celebrate 200 years of its existence in 2011)In these years that it has been around, it has been at the forefront of healthcare, be it treating patients or medical research or education. It is the kind of institution that any country would be proud to have, and I really hope that some of India's tertiary care hospitals (most of them are pretty recent) become like the MGH some day.
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