Historically healthcare has been most ‘self’ motivated to improve its ‘cost containment’ processes and methods. This is evident from the significant gap that exists between the technology and process in finance versus healthcare. Many healthcare organizations (either government or commercial) are not ‘profit’ oriented – take the Blues for example, they are all ‘non-profit’.
As we tend to see in a market economy, profit and competition breeds more effective profit and weeds out the less effective organizations. Healthcare, as a whole, has not had nearly the same market driver as other industries – there are significant local and federal regulatory restrictions, massive barriers to entry, not to mention, that healthcare (for those that can afford it) is not really optional. The result is that the healthcare industry has not moved even close to the pace of more competitive industries.
However, with all that said, it does appear that times are changing.
In the Netherlands, for example, following the introduction of a comprehensive reform package in 2006, universal medical coverage has been achieved, and not through a predominantly government-run system. The Dutch government now requires that all health insurance organizations have a comprehensive cost containment solution for fraud, waste and abuse. Which would indicate that many Dutch health organizations did not possess those type of solutions.
In the United States, the Affordable Care Act, has not only sought to introduce more competition, but also to encourage and push for better cost control. Which is interesting, seeing the number of incidents that appear in the press associated to ‘mistakes’ made by Medicare, Medicaid, VA (Veterans Affairs), etc. But any organization's efforts to improve is a good thing, and it would be wiser to encourage the effort than criticize past missteps.
So this brings us back to the primary question: Everyone realizes that the cost of healthcare is quickly out-pacing our ability to support it. But is that sufficient motivation for ‘very’ profitable organizations and governments to adjust their practices? Does all of this regulation indicate or create a ‘compelling event’ for cost containment in healthcare?
