Fred’s Ten – Questions that have been Burning my Brain


Thirty years in healthcare makes one a bit jaded.  I have been mulling over the following questions, some for many, many years. Perhaps one of you might have an answer, propose a solution or have another question to add …

  1. If the IOM says that 30% of healthcare is waste, fraud and/or abuse, why are Kaiser and other fully integrated provider/insurers not at least 20% cheaper than other plans?
  2. Why can I buy a car on eBay, but not an X-ray?
  3. Who makes the money if I improve my health?
  4. If every sector of the healthcare system says that the work they are doing is “for the patients”, why has overall health not improved given all we spend?
  5. If every sector of healthcare points to another sector saying “take the costs from that sector, they’re the problem”, doesn’t that ultimately lead back to themselves?
  6. If hospitals have such small margins, could it be they overbuilt?
  7. Can we truly continue to grow the healthcare trough and shoot for 30% of GDP?
  8. If healthcare only accounts for 10-20% of a community’s health status, why are we looking to providers to improve our health?
  9. Why are hospitals moving into selling wellness and health improvement programs in the community when healthcare costs are 10.6% higher for hospital workers than the general employee population and their health risks are 8.6% higher? Shouldn’t they show they can improve their own first?(2)
  10. Will we still be asking these same questions in 10 years?

What do you think?

(1) http://resources.iom.edu/widgets/vsrt/healthcare-waste.html

(2) Sicker and Costlier: Healthcare Utilization of U.S. Hospital Employees. Thomson Reuters, August 2011

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