[ExI] root cause analysis- towards a functional semi-automated consumer-driven economically sustainable health system paradigm

Morris Johnson mfj.eav at gmail.com
Sun Apr 6 20:10:40 UTC 2008

The dysfunctionality within health care is evidenced by the spiralling total
cost for public and private plans as well as private paid and the value of
services unrendered or unavailable for cost or regulatory reasons.

Using ABC (activity based costing) , we can document a "kazillion" instances
of cost of some billable item not showing benefits appropriate for the

Conversely those with knowledge of healthcare economics can document how
using QALY (quality adjusted life year)  math can deem some relatively low
cost ABC billed items not to be cost effective enough to cover.

The root cause is perhaps twofold.

Ist is transparancy of costs.   In Canada we do not get access to a yearly
bill describing each item and its billed cost.  Secondly some items costing
may be not tied to a single ABC and no sidenote to describe the contributing
cost factors is made available.

2nd and I feel most important is the inability and unwillingness to allow
any citizen to have full access to any health related information so that
they can independantly decide what action they want.  The major players are
comfortable to work privately with regulators and screen information.
Doctors and other gatekeepers are not designed to be educators as they
must first manage the crisis cases and the routine tasks before anthing
There are better ways to deliver health information than the traditional
The alternative medicine consultation system has good intentions but also
its own sales adjendas.
The logical delivery is the lay media.
Regulators have made it nearly illegal to provide really unlimited access to
fundamental science information.

Dumbed down lay media and approved advertising is perhaps the root cause of
the health care economic crisis.

I spend time anytime I want to search various university based journal ,
media and trade information sources.
The ordinary person either cannot or chooses not to do this.

As a health product manufacturer I would have a much easier time to find my
target market if they were more informed.

Governments might rather have dumb citizens who are managed, but I do not
believe they have a vision of how
an open information access system might revitalize the crisis-managment
portion so that it can deliver
those items less often to fewer customers.

In effect this automates a self-driven health management protocol.

So in reflection much as automation has made mass produced consumer goods
possible , and automation of communication is the basis of the global
communications net perhaps a new automation of diagnosis, consultation and
personally driven health management paradigm.

Morris Johnson
Box 10, Beaubier, Sk., S0C-0H0
Canada   306-447-4944  ;  701-240-9411

Message: 25
Date: Sun, 06 Apr 2008 05:07:22 -0400
From: ablainey at aol.com
Subject: Re: [ExI] Health system, again
To: extropy-chat at lists.extropy.org
Message-ID: <8CA65DCC17359C0-E2C-42DB at WEBMAIL-DG15.sim.aol.com>
Content-Type: text/plain; charset="us-ascii"

Anywhere that there is an interface between two organisations which charge
each other for a service or product, there is wastage. This is true of any
commercial bodies such as in a private health system and Even in fully
publicly funded systems such as a national health service. In the case of
national services, this is usually done to bolster inadequate budgets, but
also because many people in the system get bonuses of some kind which they
try to maximise.
There is always someone skimming off the cream at these interfaces and it is
fully accepted.
For some reason we don't like the idea of paying for someone else's health
cover, Smokers being a prime example. But we have no problem paying for the
CEO's new yauht and a box full of Cuban cigars.
Cost cutting exercises, streamlining and?scrutiny of the system?generally
forces these costs down through the chain to the first interfaces, so a
tampon cost's $1200
Its a shame that such an expensive tampon can't be used to stop the
heamorage of money!


ginal Message-----
From: Kevin Freels kevinfreels at insightbb.com

Personally I think that the concept of health insurance is what has caused
the skyrocketing costs in the first place. People no longer saw nor cared
what they were being charged because someone else was paying the bill so the
market forces controlling costs were removed. It's the cost of BS we all

For example - four years ago I took my 9 yr old daughter to the ER at 3 am
because she had a nosebleed that started at 9pm and hadn't stopped. We
waited 3 hours, then saw a Dr for 10 minutes who crammed what looked like a
small tampon up her nose and sent her home. My cost was $75 for the ER
visit. When I later looked up the detailed billing out of curiosity, I saw
that the Dr charge was $440 for the 15 minutes and the "tampon" cost $1200!
Plus there was another $300 worth of supplies and such. I called and asked
the hospital about this obvious error and they said that yes, the bill was
correct, the "medical device" they put in her nose was "medicated". I was
supposed to return in 3 days to have it removed which would have been a $25
co-pay office visit ($120 in insurance), but just to spite the system, I
pulled the thing out myself with no trouble at all and the bleeding was
obviously gone.

I have no idea why nobody wants to address this issue. If Drs are in such
short supply, maybe allowing more into medical school or? allowing?
practicing nurses to? do more would be in order and help to drive some of
these costs down. I think that the free market isn;t working because the
market is not free.

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