Is Our Healthcare System Broken?

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I think we don't only have a healthcare system, we have a bunch of systems. I'm shocked to see many layers to them and many of them work differently and I think one of the major things that's somewhat wrong with it and I'll steal a line from my friend Dr. Dean Ornish is that we don't practice evidence based medicine we practice, reimbursement based medicine and the incentives in many cases are radically misaligned from what would be real healthcare.

It's there are we have sick care not really health care. So broadly speaking, it's where the incentives lie which drives how our system works in many cases these are broken. For example in hospital many times we'll have line infections, someone who is in the Intensive Care Unit, will have complications from a maybe a relatively simple surgery but then ends up snowballing and they can bill for those elements.

I believe now Medicare and others are creating situations where there is no reimbursements for certain types of complications which is a good way to be. We know that in the last year reimbursement also if you are re-admitted for a congestive heart failure within the month, you won't be re-admitted, which is making sure we're not kicking folks out of the hospital too early, and doing a better job of managing them at home, which technology can certainly enable in smarter ways.

So, you know, as a physician now most are paid fee-for-service, for doing the biopsy, doing the the bypass surgery, treating you after a condition has progressed, there's relatively little incentive for most clinicians or hospital systems into keeping you healthy or keeping your disease in a moderate sense.

And that probably goes through the bio-pharm industry as well, if it's a single therapy, one pill that cures your disease, it's wonderful for you and as the patient, but that doesn't give continuing revenue. So, it's sort of human nature in the way organizations and big companies have sort of set up that, you get paid for what you do instead of what we do, often this is driven by illness and later stage disease not prevention, early diagnosis and wellness.