03 Mar A conspiracy of fools

Remember when we were in grade school? How many kids in our class did we think were really “smart”? How many did we think were “wicked smart”? Guess what happened in the intervening years – we all grew up and became professionals in one field or another. Guess also what happened to the number of people we deemed smart (or not so smart) in the same group – it did not change. (Unlike wine, people do not improve “intrinsically” with age. They may otherwise if they are conscious of the deficiencies and have the desire and the discipline and humility to change).

Now guess what all those people you knew were not so smart are doing now? They are working all around us. With us. Against us. Some of them are making public policies that we are all obliged to live and die by. We are surrounded by people that we know are “less than smart”. It could even be you or me.

Let’s take this life experience and apply it to just one field – healthcare. I read all these articles in all these places pontificating about the “cost of healthcare” that is out of control. Fingers get pointed at physicians and pharmaceuticals and medical device makers. Fingers are pointed at everything and anything except one that stands out – Hospitals. Isn’t it strange that not a single article on LinkedIn or any other site points even an inquisitive finger at Hospitals as “a” probable cause of escalating healthcare costs in this country. I postulate that this can only be due to a “conspiracy of the fools”. The same less than smart people from grade school somehow have managed to get a hold of our healthcare system from a “business” viewpoint. These fools are making tremendous amounts of money (follow the private equity group bets in healthcare vs. the economy at large). Why is it that no one talks about the “numbers”. Come on man, when you talk about cost, it is ALL about numbers:
Revenue – Cost = Profit.
Does anyone not get this?
So if we want to reduce the cost of healthcare in our great country, why in the world are we not looking at what the hospitals are doing to drive up the cost of individual procedures that cumulatively drive up the overall healthcare costs?

Do I need to really break this down any further? Does anyone really not understand this? It is fine if I have to but for goodness sake, let’s have an honest discourse on this and not pretend that the root cause lies elsewhere. It is the hospitals – o’smartone!