Is There a Single Cause for Our Healthcare System Issues?

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I don't think you can point at a single thing. We've had a concatenation of events that have targeted and created the problem, sort of heavy investment in hospitals, a payment for people to do more, research has created ever more technology some of it really fantastic, but some of it quite marginal, if not of no benefit at all that gets rewarded within in the system.

We've taken really talented people and put them under stressful circumstances, both financially, ethically as well as clinically, and it seems to me that we have not said alright, what's the kind of healthcare system that is going to have our system, and incentivised to keep people healthy, keep them out of hospital, keep them functioning as long as possible.

Now here is the fee-for-service reimbursement, part of the problem? Absolutely, in a system where there is no global budget, and no way of sort of rationally deciding, 15% or 20% of GDP is going to healthcare, but we're not spending over more every year, fee-for-service in that kind of circumstance really does generate very strong upward pressure on how much we're spending on healthcare, and it also doesn't incentivise people to keep patients healthy, it does just the opposite.