Tag Archives: Healthcare Costs

A Letter from Dr. Shetty and the Costs of Care

Sometimes we here in the United States, me included, when dealing with all the problems we face with our healthcare system need to step back and understand why we are really here. In the end, it is about the patient, the person needing help.

If I had my druthers I would do nothing but work in Medicaid.  After spending almost 20 years providing disease management services to Medicaid programs and running a Medicaid health plan, the joy of helping this population improve their health has always felt like the pinnacle of my work.

While much of what we have done and continue to do is laudable, there are many flaws with our healthcare system, we spend too much, get too little, and are constantly looking for new solutions to the unique problems the system we created, creates. It seems as if we harp on the negative, but is it really negative to harp on the waste, inefficiencies, fraud and abuse, to point out these wrongs in an effort to fix them?

Recently I received a copy of a letter written by Dr. Devi Shetty. He is a world-renowned heart surgeon, but more importantly he is a heart surgeon who says about healthcare:


   “If the solution isn’t affordable, it’s not a solution,”


“For 92 per cent of people living on this planet, heart surgery is a distant dream,”

Continue reading

Leave a comment

Filed under Healthcare Costs

Employers, unions look to direct contracting for health system contracts

Brian Klepper and I just published a piece entitled:

Employers, unions look to direct contracting for health system contracts

Some key points:

“Industry denials notwithstanding, reducing healthcare costs is fundamentally against nearly every healthcare organization’s perceived economic interests.”

“Florida’s Gov. Rick Scott, former CEO of Hospital Corporation of America, pointed out at a venture capital conference a few years ago, ‘What business wants to make half this year what they did last year? That’s why the healthcare industry won’t fix the healthcare industry.’ “

So purchasers beware. You can read the article by clicking the link to the story at Employee Benefit News:


And if you’d like to learn ways to lower your healthcare costs, contact Brian or me at Health Value Direct


Leave a comment

Filed under Healthcare Costs

Health City Cayman Island – Medical Tourism May be One Way to Lower Healthcare Costs

Health City Cayman Island


I recently had the pleasure of visiting Health City Cayman Islands (HCCI), a medical facility founded by Dr. Devi Shetty in a relationship between Narayana Health and Ascension. A group of individuals from the United States toured the hospital and had an opportunity to meet with and ask questions of the staff including the senior physicians for the surgical areas.

Although I was on the island for less than 20 hours, it goes without saying that Grand Cayman is beautiful and the ocean was oh so inviting. Next time I’ll have to spend a bit more time and enjoy the amenities including what the locals refer to as CaymanKind, but back to the purpose of the trip.

Continue reading


Filed under Uncategorized

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

Leave a comment

Filed under Uncategorized