Wednesday, July 15, 2009
From the baseball all star game to the Tour de France and golf’s British Open, the ability to measure athletic performance allows fans to decide who are the best of the best. Unfortunately, statistics don’t often translate well to the real world. This is especially true in medicine. While government websites tout their ability to help patients decide what hospital offers the best care (www.hospitalcompare.gov), most people don’t have the opportunity to pick and choose where and when they get care. And the numbers are a lot harder to interpret than batting averages and ERAs.
While the outcomes can be measured for each hospital, the real care is provided by people: doctors, nurse, technicians and numerous support people need to perform well for the patient to benefit. In emergency situations, the average patient doesn’t get to pick the all-star staff of that specific hospital. Even if the real issues of money and insurance are ignored, most people are bound by geography for their medical care choice. In towns across the country, small hospitals have closed, leaving many with long drives should emergency situations arise. And in large cities, how does one decide which hospital to choose? Patients may be in crisis and their families cannot be expected to know which hospital specializes in stroke care, heart attack, trauma or children. They often rely on an ambulance protocol that sends them to either the closest hospital or ideally one that is best able to care for their needs.
Fortunately, this is where information is king. Talking with family and friends, questioning the family doctor and searching the internet allow people to understand what medical resources are available in their community.
Sports may also give as some insight into the health care reform where the hope is to provide medical services to everybody in the country at an affordable price. Unfortunately, there is bountiful and seemingly unlimited demand for medical care. Too often, the health care system is responsible for repairing the poor decision making of the individual patient. Whether smoking, excessive alcohol consumption or obesity, the burden of repair falls upon the health care dollar. As science advances more of the self- inflicted damage can be repaired….at a price.
Football, basketball and hockey have salary caps that require general managers to decide how much to spend on a budding superstar and yet be able to surround that player with a team. They also have the option of structuring contracts to push those tough decisions into the future and leave it to another time to balance the salary budget. In baseball, there is no salary cap and teams are free to spend as they wish. All they have to do is pay a tax if they go over budget.
It may be that the health care debate will spill over into the demand part of the equation. As an example, the federal government makes money on tobacco and alcohol sales and actually subsidizes those sales to the armed services. And will the decision makers be willing to make the hard choices and not “pay a tax” or push the decision off on future congresses.