In a recent episode of Unfiltered, Dr. Jonathan Fisher and I discussed the idea of abundance and scarcity and medicine, debating which areas of American healthcare have “too much” and “not enough.” We asked readers of this newsletters and listeners of the podcast to weigh in. Here are the results:
My thoughts: I agree with readers who say healthcare costs are too high, telemedicine is underutilized and surgical procedures excessive.
The question is: how can we change medical practice in ways that actually improve clinical outcomes for patients? To quote Charlie Munger, financial partner of Warren Buffet: “Show me the incentive, I will show you the outcome.”
Relating to healthcare, it’s difficult to imagine a fee-for-service reimbursement system producing any other result than the one we’ve witnessed for decades: high costs, perverse incentives and excessive care. So, for as long as fee-for-service remains the incentive mechanism for healthcare providers, we should expect the same failed outcomes.
Thanks to all who voted! To participate in future surveys, and for access to timely news and opinion on American healthcare, sign up for my free (and ad-free) newsletter Monthly Musings on American Healthcare.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. All profits from the book go to Doctors Without Borders.
