A personal tragedy caused David Goldhill to examine the absurdities of the U.S. health care system.
In 2007, his father died of an infection acquired in the intensive care unit of a respected New York hospital. Although 83, Goldhill’s father was still working when he was admitted with pneumonia. Over the next five weeks, multiple hospital-acquired infections overwhelmed his defenses.
This was a tragedy for Goldhill and his family. But he learned it wasn’t that unusual. About 100,000 people die each year from hospital-acquired infections, more than double the number of people killed in car crashes in a year.
Goldhill wondered why Americans accept this as inevitable. His questions – and conclusions – led him to write an article in The Atlantic that he expanded into a book, “Catastrophic Care: How American Health Care Killed My Father – And How We Can Fix It.”
Goldhill, CEO of the Game Show Network, was keynote speaker last month at the annual meeting of the Association of Health Care Journalists in Boston. He explained his ideas for transforming the “backward economic incentives baked into the system.”
“I’m a businessman, and I’ve never worked in the health care industry,” Goldhill writes. “But like the rest of us, I’m also often a patient and so I can’t help noticing that the industry of health care simply doesn’t measure up to the standards of other industries in our economy.”
For example, Goldhill said, patients going into the hospital are often advised, even by doctors and nurses, that they should always be accompanied by a friend or relative who can watch out for mistakes.
Imagine, he said, going to Fed Ex to send a package and being told by the clerk that you should “stay with your packages at all times.”
“Every business would like to get away with high prices, poor quality, and miserable service,” Goldhill writes, “but this behavior carries an unacceptable cost: lost customers, lost revenue, lost profits.
“In health care, bad behavior doesn’t produce these bad results; bad behavior is often rewarded with additional revenue, and efficiency is penalized with less.”
Goldhill’s proposed remedy is unconventional and controversial:
• Dump the insurance-based model, which “drives excess treatment, cost inflation and medical errors.” But he would keep a health insurance program to cover all Americans, from cradle to grave, for “truly insurable events; health crises that are major, rare and unpredictable.”
• Make the system accountable to consumers by shifting “many of the enormous resources now passing through insurance and government programs back to us.”
• Get government out of the business of paying for medical care so it can advocate for consumers by “promoting transparency and competition, driving the collection and dissemination of data, and punishing (rather than funding) those who practice unsafe care.”
It’s a provocative idea. One we should at least be talking about.
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