“The United States is spending 13% (or 18% or whatever other percentage is handy) of its GDP on health care, and the percentage is increasing, with no end in sight.” Gloom and doom! Our country/our economy/our way of life will be destroyed.
Nonsense! Percentage of GDP is the wrong metric (benchmark). Let me show you why.
Recall the advent in corporate America of the Chief Information Officer. One of the driving forces behind the creation of this job was a prevalent feeling in the executive suite that companies were spending too much money on IT, and some adult supervision was in order. And even cases where a CIO was not initially tasked with controlling overall IT expenditures, he or she soon realized that this was a very hot topic, one that had to be addressed.
But as popular as this topic was in the board room, it made no sense to the people running the business. A business manager needs the ability to apply his resources (money, people) to whatever facet of the business will yield the greatest returns. Build a new system to track sales operations, or, spend the money on product rebates – whatever works best. The fact that doing these things shifts certain expenses from one line item in the budget to another should have no influence on the decision.
To see just how silly this metric is, try this thought experiment. Suppose all elements that make up the GDP were held constant at their current levels and suppose that health care consumed 13% of the GDP. Next assume that one and only one element of the GDP changed – say defense expenditures fell by one third., What would happen to health care expenditure as a percentage of GDP? It would go UP, although no one would be getting any more health care! Percentage of GDP is an attractive thing to measure because it can be measured. But it really does not mean a thing.
What is left out of this discussion is any consideration of patient wants and needs. The patient may prefer a dietetic consultation or an unusually detailed annual physical exam (health care expenditures) to a Caribbean vacation or a new car (different line items in his budget.) Every person should have the right to re-allocate his resources to or from health care without regard to some arbitrary politically imposed limit.
Over the years, we have learned in the IT world that the only thing that makes sense is to supply to the user those capabilities that the user specifies, because the user knows much more about what is important than any bureaucrat (like the CIO.) Why is it so hard to acknowledge the need for patient (user) primacy in health care decisions?
Gerry Hoffman
Need to subscribe to this blog, great post. Found it on yahoo.