"The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults."
By this we know very quickly that their facts will be suspect. Since they will be consciously or unconsciously looking for interpretations that fit their Worldview and Mission. With this in mind, what grading factors would you propose for a Successful Healthcare System? And how would you weight them? Not how to attain it, or what is wrong today or with ACA, but how would you grade one?
See Decision Matrix links... We are not scoring, discussing options or fixing... Just discussing the ~10 key factors that we see as important.
The Commonwealth Fund
CW Fund Criteria
G2A Decision Matrix
G2A Decision Matrix 2
5 comments:
When I think of rating or comparing health care systems the three overriding factors that come to my mind and seem obvious to me are the ones mentioned by the Commonwealth Fund; quality, access, and effciency (cost.) As considered for all. Is it their focus on the poor that makes you suspect?
I am about ready to move on from this topic, but will likely be drawn into commenting by your take on it, which will likely be different from my perspective. Your mention of 10 key factors already sounds too deep into the details for me. The part about weighting factors could be interesting. I previously put the big three factors in order of importance as access, cost and quality, but I believe that is really in order of what I see as needing the most improvement in our health care system.
Don't peter out on me now. What are your definitions of these factors and how much weight would you give each? If you want some hints, the CW Matrix has a bunch of drop downs.
My first thoughts:
Access
- Freedom to choose Doctor/Clinic
- Can get treated there in a timely manner
Quality
- Best Doctors, Nurses, Staff ($$$)
- Best Equipment ($$$)
- Doctor & Patient choose
Efficiency
- Minimal bureaucratic costs (money goes to treatment)
- Active competition
- Effective treatments
- Plenty of R&D and Improvement ($$$)
User Pays (most of the time)
- Customer sees and pays bill (incent them to watch for fraud and unecessary treatments)
- Consequences of poor health behaviors and other life choices are not carried by everyone. Individual bears brunt of consequence of having made poor choices.
- All citizens contribute actively and benefit is relative to contribution. Incent citizens to work hard to help cover their own healthcare costs. Not free loading off the wealthy and hard working. Incents citizens to only have as many children as they can afford.
So I guess that is why I question their numbers and facts. If they believe access and free coverage are rights, no matter how folks choose to live their lives. And they are happy to have the wealthy and hard working pay the tab. They probably will come out with a different result.
sorry, due to another lost (not copied ) comment I am ditching this topic for now. If you decide to delve deeper into this complex issue, my strongest interest is in the rising cost aspect, for myself and everybody else. I'd like to have some discretionary income left each month to enjoy life now (i.e theater, vacations, etc.) rather than pay more and more exhorbitant premiums in a costly high tech system designed to spend large amts extending life at the end (as was done for my dad.)
It seems that you are interested in cost/payment aspect as well, though are likely to take it in a different direction than I would. Your reference to free loaders is a hint of thoughts to come.
Remember... A significant amount of those high costs goes to support those that choose to be uninsured. (ie free loaders) Maybe they are spending your discretionary money on their vacation, etc. Interesting thought...
Sorry for the lost comment. I'll start researching the topic.
Laurie, if you are still out there, I refer you to one of the fundamental tenets of project management. There are three things one can control in any project--time, quality of result, and cost. Pick any two, and I will tell you what happens to the third. Pick all three and you can find somebody else, because it isn't possible to control all three. Not even if you're the government.
Post a Comment