Because They Count Deaths, We Don’t Get Life

There are so many things wrong with healthcare it may be hard to begin the list. Possibly the place to start is what healthcare calls success: what they keep track of, their results.
Every good manager and every operations expert will tell you the same thing: you get what you measure. What the people-in-charge say is important is what the workers will focus on. What workers pay closer attention to gets done better, quicker and cheaper. That is why customers get what managers – people who write paychecks – measure.
If what the workers constantly hear is ‘cut costs, cut costs,’ then what obviously matters is spending less. What the consumer wants tends to gets lost. What results do we – the consumers, also known as patients – want from healthcare?
We want: a) To live a long time; b) To be healthy while we are alive; and c) To enjoy life, which requires making wise use of what money we have. If you get what you measure, then healthcare should measure precisely what we want: a) Long life; b) Healthy bodies and minds; and c) Value received for dollars spent. Healthcare does not measure any of those outcomes.
Health care keeps track only of “negative surrogates” like deaths, complications, and costs. They do this because such measures are easier to track than what we really want: life, health, and value.
Managers in healthcare believe that if you invert a measurement of what we don’t want, you get a measure of what we do want. So the absence of deaths is Regulation On Food Supplements a measure of life and the absence of complications means we are getting quality medical care. The proper response to such reasoning is “Horsefeathers!”
Not being dead may seem the same as being alive, but a) what about the quality of life, and b) alive for how long? You can be alive but paralyzed from the waist down. Surgical success is defined as living for 30 days after operation. Even if you drop dead on day #31, you are still a surgical success. As you can see, there are fundamental problems when healthcare uses negative surrogates as substitutes for the positive outcomes we want.
Not only does healthcare measure the wrong results, they do it badly. Typically, you hear relative measures like 17% of patients had side effects, or there is one error per patient for every day in hospital. My wife had a friend who used to brag that 17% of his high school graduating class went to Harvard. What he did not bother to mention is that there were six people in his class. As for those everyday hospital errors, what if no patients were harmed?
Possibly the worst mistake healthcare makes when measuring outcomes is the timeline. They keep track of immediate results yet what we truly want is years or even decades in the future. We want to live long and prosper (as Mr. Spock said on Star Trek). So, what healthcare should be measuring is how healthy we are and how healthy we stay over the years.
When it comes to money, healthcare focuses exclusively on immediate cost, initial outlay, and next month’s budget. This short timeline makes healthcare penny wise, pound stupid (not just “foolish”). No one calculates avoided costs. No one measures productivity changes. No one tracks anything long-term.
Several years ago to balance its budget, my home state of New Mexico cut out “unnecessary” items from the healthcare budget. In so doing, they saved almost $800,000 and eliminated the Childhood Asthma Prevention Program. No one kept track of the increase in hospital admissions for asthma, which have been estimated to cost over $4 million.
By using blinders and seeing only immediate spending, New Mexico healthcare saved $800,000 and spent $3.2 million dollars it did not have to. How To Be A Healthy Person Essay Had they kept focus on what we really care about – long-term, net cost – they would not have cut asthma prevention. Penny wise, pound stupid!
Healthcare measures the outcomes we don’t want. No wonder we get the outcomes we don’t want.