August 8, 2010 by David Gillaspie
You want healthcare reform? Do you want healthcare reform? You can’t handle healthcare reform.
(with thanks to Jack Nicholson as Colonel Nathan R. Jessup and THE TRUTH in A Few Good Men.)
The numbers are out there. The percentage of resources spent on end-of-life care, the huge profit margins the drug companies they say they don’t get, the cost of mal-practice insurance, it’s all there if you dig for it.
You don’t need an Informatician (hey Jason) with a rattle can to tag that wall.
If the main focus on healthcare reform is cost, what would the system be like if it was free?
Let’s look to our European brothers for the best example, since Europe and America are so similar.
Healthcare in Spain is free, so that’s a good focal point. Besides being the nation the U.S. defeated in battle to gain a seat around the big boy table just before the turn of the 1900’s, Spain once ruled the world. They know how to get things done right.
To begin with, does a hospital really need to look like an upscale shopping mall? Spain thinks not. Find a chunk of land in an urban center and start building. Start with a cement wall with a wrought iron fence on top. If you have trouble imagining this look, go to the zoo for the lion habitat. Same deal, minus the lions.
Does a hospital require an artistic entryway designed to sooth and comfort? Why? Spain paves their entryway/moto-cross track with bad asphalt and cobblestones. If a visitor breaks an ankle dodging dirt bikes and scooters on the way to the front door, no big deal. Treatment is free.
Landscaping is an often overlooked cost in modern medicine. Not in Spain. Dirt was good enough for the Romans and they lasted a thousand years. Why change? Drop in a few orange trees, let the oranges ripen and fall and get tromped into the dirt and you’ve got all the landscaping you need. You also get bugs, but they are natural bugs.
Is outside grounds maintenance important? If it’s not important on the inside why bother with the outside? Besides, the doctors, nurses, patients, and visitors will only throw another layer of cigarette butts down if you sweep any up. Better to mix the butts and the orange mush into the bad asphalt and call it an organic macadam surface.
More savings come by eliminating inside janitorial services. If there’s a spill of liquids on the ward floor just toss a chuck on it, maybe two. Spain is smart enough to walk around it, why not America?
Security and patient ID are a waste of money in Spain. When a sign says only two visitors per patient, it really means invite everyone on the block. There’s nothing more beneficial and motivating to an ill person than having a ring of people surround their bed and yell at them all day and night. You’d want to get better.
It takes a village to raise a child, and the same village will show up in Spain and kick the grown child’s ass when they are in the hospital. Down and out is no excuse. If the village can’t get you to wear the oxygen mask and take your pill, they get the nurse to come in and give you hell. Again, it’s all about motivation.
What if a patient in Spain needs a doctor over the weekend? They are smarter than that. Spain plans their illnesses according to the doctor’s schedule, and doctor is not in over the weekend. That’s real savings for the medical consumer, and eases the medical payroll.
Could America adapt to the Spanish model? Why not. If you look into a county hospital in lower economic areas you’d think it’s already happening. Do the walls have holes punched in them? Is the flooring broken and cracked? Does the elevator only go to certain floors? Is the interior painted with what looks like remaindered paint mixed together in colors no rainbow has ever produced?
If healthcare reform in America is all about cutting costs, this is a roadmap. Never mind that the car has no gasoline, no tires, and no engine, just climb in and hang on.
Feeling better yet? You will by Monday.