Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
Grok Headline matches for Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
Kerry Blames Rising Health Costs for Job
Losses (Reuters)
Kerry Blames Rising Health Costs for Job
Losses (Reuters)
08/19/2004 03:58 AMReuters - Democrat John Kerry, citing a newly
commissioned study, said on Thursday that rising health care
expenses have cost American jobs and President Bush has done
nothing to solve the problem.
Kerry Bashes Bush on Health Care Costs
(AP)
Kerry Bashes Bush on Health Care Costs
(AP)
05/10/2004 03:03 PMAP - Democratic presidential candidate John Kerry said Monday his
health care proposal to reduce soaring premiums and cut fraud and
waste is the remedy for a system "badly broken" under President Bush.
Making 'Sense' of Health Care Costs and
Other Complex Challenges
Making 'Sense' of Health Care Costs and
Other Complex Challenges
06/05/2005 11:12 PM
When
does the pursuit of 'best practices' make sense, and when do we need
to
apply less precise but more effective approaches instead?
 This week's New Yorker has another interesting
column by James Surowiecki, entitled Local Knowledge,
which laments the fact that there are huge anomalies in health care in
the US from community to community, a result of a combination of local
customs, patient demographics, and the varying supply and
accessibility
of practitioners and facilities. Great variations in treatment have
been noted in many diseases and conditions, including serious and
controversial ones like cesarean sections, spinal fusions,
mastectomies, and coronary-bypass surgeries. Different treatments and
variances in hospital stays mean great variations in medical cost,
Surowiecki says, and this could be costing the US health care system
billions it can't afford. His prescription? Not a new government
standards body, but increasing awareness of people about these
differences, so that the 'inefficiencies' are driven out of the system
by informed patients and caregivers.
What Surowiecki seems to be looking for is what in business is called
'best practices'. What's interesting to me is that business has
recently become disenchanted with 'best practices': In a world where
every job, every situation, every context is different, the
applicability of some documented 'best practice' in any situation
other
than the one it was identified in is increasingly dubious. Dave
Snowden
articulates these three
'heuristics' about real-world knowledge:
Knowledge can only be
volunteered; it can't be conscripted.
People always know more than they can tell and can tell more than they
can write.
People only know what they know when they need to know it. Human
knowledge is contextual and triggered by circumstance.
So what we have here is a clash of two new and exciting philosophies:
Surowiecki's argument that tapping the Wisdom of
Crowds
can allow much better answers to emerge than relying on experts,
versus
Snowden's argument that such 'wisdom' is possible and useful only in
relatively simple situations where apples can clearly be compared to
apples, and doesn't
work in the majority of more complex situations where every case
is arguably significantly different.
An identified 'problem' in Surowiecki's article is the large number of
facilities and practitioners providing over-long stays to patients in
Florida, compared to other states. They are drawn there, of course,
because that's where the customers are, and, as in all things, the
work
tends to expand to fill the available space, money and time. In public
health services we seem to try to offset these 'market' tendencies by
making sure both facilities and practitioners' time are in constant
short supply, in the presumption that this will yield less waste and
force greater efficiency, rather than posing a serious threat to
public
health. And this is exactly the problem with applying mechanistic,
industrial, simple-situation prescriptions to complex-situation
challenges.
So what should we do when doctors in one community perform
appendectomies and tonsillectomies four times as often as they do in
the next community, of the same size, a stone's throw away? Surowiecki
thinks we need to figure out "how to pay doctors for the quality,
rather than the quantity, of the care they provide" and hopes that
"eventually people will start paying attention to the data and
recognize how costly these variations can be". But even he seems
dubious of the possibility of either of these things happening. Of
course patients need to be better informed about preventative health
care, self-treatment and new knowledge about less invasive and
unnecessary procedures. But health care isn't like widgets, where
differences in 'unit' product cost, quality and service are
conspicuous. Every situation is truly different, and we'll never come
up with either a formula for determining the right health care answer,
or an expert system that will tell us precisely where the
'inefficiencies' in health care are and how they can be
eliminated.
Surowiecki suggests the problem is geography and parochialism. But
geography is just one way of slicing community, and these days it's
not
even the most important one. The issue isn't isolation of community,
it's incomparability of situations with infinitely many different
contexts. When the data is a million cases of one, the significance of
patterns is likely to be illusory.
And health care isn't the exception either -- most of the products and
services that are essential to human well-being, like education,
nutrition, freedom, justice, security, transparency of government and
a
healthy environment are also enormously contextual, circumstantial and
relative. Experts and advocates in these fields have torn out their
hair trying to find benchmarks, standards, measures, scorecards and
'best practices' that will allow us to cajole improvements in
performance from those we assess to be falling short. It can't be
done.
Complicated solutions don't solve complex problems.
The essence of Snowden's new approach to
sense-making
and management 'science' is to first assess whether the situation
lends
itself to simple-to-complicated solutions and approaches (like root
cause analysis, systems thinking and The Wisdom of Crowds), or if it
requires more complex approaches (like cultural anthropology,
pattern-seeking, Open Space and emergent understanding techniques like
the AHA! Discovery Framework diagrammed above). It doesn't take much
thought to realize (a) that most of the challenges we face in business
and society today are complex, and (b) attempts to force simple and
complicated-situation solutions in complex situations, like the
deliberate starving of the health and education systems (and like the
ubiquitous imposition of lousy
service
in all areas of business today), in the ill-conceived belief these
will
somehow mechanically force efficiency and productivity improvements in
them, are doomed to make the situations worse, not better.
It's time we woke up to the realization that industrial-age solutions
are increasingly inapplicable in the information age, and it's time we
got over our discomfort with the imprecision, uncertainty, lack of
causality, and non-amenability to command-and-control hierarchy that
complex approaches entail. Managers, grit your teeth and prepare for
some revolutionary new, difficult and important learning.
So sorry, health care fans desperate for solutions to spiraling costs.
No 'best practices' or 'popular wisdom' answers here. Move along,
please.
|
Health-care costs shoot up, millions in
U.S. left gasping
Health-care costs shoot up, millions in
U.S. left gasping
07/04/2004 12:09 PM
Health-care costs shoot up, millions in U.S. left
gasping "...there are signs of growing frustration. The
Gallup Organization reported in January that for the first time since
1992, when Americans are polled about urgent health problems facing
the country, the cost of health care is No. 1, ahead of issues such as
cancer, obesity, and smoking..."
Kerry decries outsourcing, speaks of
health care, tech
Kerry decries outsourcing, speaks of
health care, tech
07/30/2004 05:24 AMThe U.S. should close tax loopholes that provide incentives to
companies that want to ship jobs to other countries, provide its
military with the most advanced technology, while also focusing on
security and improving the health-care system, Democratic presidential
nominee John Kerry said Thursday night in a wide-ranging speech
accepting his party's nomination.
Report: Consistent IT Can Bridge Gaps in
Health Care
Report: Consistent IT Can Bridge Gaps in
Health Care
09/16/2004 09:16 PMA new report from the Institute of Medicine blames much of the health
care system's inadequacies on fragmentation and says IT can play a key
role in a more integrated, patient-centric approach.
4 Rising Stars for 2005. Special Report
- Sponsored Link
4 Rising Stars for 2005. Special Report
- Sponsored Link
06/17/2005 04:29 PMAd - http://www.risingstarstocks.com Jun 17 2005 8:23PM GMT
AHLA - Links to Selected Health Care and
Health Law Sites
AHLA - Links to Selected Health Care and
Health Law Sites
11/10/2003 10:50 PMAHLA - Links to Selected Health Care and Health Law
Siteshttp:
//www.healthlawyers.org/weblinks/weblinks_health.cfmAmerican Health Lawyers Association comprehensive set of links to
selected healthcare and health law sites.
The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies
The Rueckert-Hartman School for Health
Professions, Regis University, Denver,
CO, Announces the Formation of the
Center for Health Care Ethics and
Emerging Technologies
06/05/2005 11:58 PMUnder the direction of Dr. Pat Ladewig, Dean, Rueckert-Hartman School
for Health Professions, Regis University established the Center for
Health Care Ethics and Emerging Technologies. Dr. Mark Meaney,
Executive Director, stated that the goals of the Center include the
examination of the ethical and social implications of emerging
biotechnologies such as nanobiotechnologies, pharmacogenomics, and
stem cell research. [PRWEB May 22, 2005]
"Report on the Intelligence Community's
Prewar Intelligence Assessments on Iraq,
Ordered reported on July 7, 2004"
"Report on the Intelligence Community's
Prewar Intelligence Assessments on Iraq,
Ordered reported on July 7, 2004"
07/11/2004 09:57 PMReport on the U.S. Intelligence
Community's Prewar Intelligence
Assessments on Iraq
Report on the U.S. Intelligence
Community's Prewar Intelligence
Assessments on Iraq
07/10/2004 02:34 PMrapport .. pdf
intelligence.senate.gov/iraqreport2.pdf
track this
site | 5 links
Discussion: Your thoughts on the
outsourcing/offshoring trend
Discussion: Your thoughts on the
outsourcing/offshoring trend
07/19/2004 06:16 AMCNET Jul 19 2004 10:08AM GMT
Outsourcing still rising: Gartner
Outsourcing still rising: Gartner
05/18/2004 02:44 AMZDNet Australia May 18 2004 6:51AM GMT
Revamping Costs and Rising Yen Hurt Sony
Profit
Revamping Costs and Rising Yen Hurt Sony
Profit
01/29/2004 01:47 AMProfit at the Sony fell 26 percent in the October to December quarter,
hurt by restructuring costs and declining revenue in the movie and
video game divisions.
Dell reports higher profits, rising
costs
Dell reports higher profits, rising
costs
05/13/2004 09:16 PMSiliconValley.com May 14 2004 1:22AM GMT
Survey Finds Pay Rising in Health IT
Survey Finds Pay Rising in Health IT
09/17/2004 09:40 PMThe HIMSS survey found that three-quarters of health IT professionals
got raises last year, with those at consulting firms netting the
biggest paychecks.
Wipro: R&D Budgets Falling, Interest in
Global Outsourcing Rising
Wipro: R&D Budgets Falling, Interest in
Global Outsourcing Rising
04/02/2005 08:31 PMInformation Week Apr 3 2005 12:59AM GMT
More health care have-nots
More health care have-nots
07/01/2004 01:45 PMHealth-Care Opportunity
Health-Care Opportunity
02/11/2004 03:12 PMHealth Net looks like a value-priced managed care company.
GE Bets on Health Care
GE Bets on Health Care
04/13/2004 02:20 PMClosing a $9.5 billion deal for the U.K.'s Amersham assures a major
role for GE Healthcare.
The Health Care Implosion
The Health Care Implosion
05/25/2004 01:22 PMMercury News: Health costs hurting more small businesses. The cost of
health insurance -- ranked the top concern of small businesses since
1986 -- still holds that dubious distinction, a new nationwide survey
shows. But the percentage of firms affected by those costs has grown
substantially.
The health care system, or at least
the insurance system through which our health-care dollars flow, is in
a slow-motion collapse. This story is just one more data point.
Sooner or later, we'll have to make a choice. Should the U.S. go to
national health care, as every single other industrialized nation
provides for its citizens? Or should we go to a totally free-market
system -- not the bogus pretense of one we have now -- that leaves
millions without care of any kind? Or something else?
The insurance industry is systematically excluding people who will
someday need care -- shifting costs wherever possible to taxpayers.
This may be rational capitalism, but it's lousy public policy.
I'm working on some columns on this topic.
Let
me know what you think.
Here's to Your (Cheaper) Health Care
Here's to Your (Cheaper) Health Care
09/16/2004 03:27 PMMore Americans are looking to Canada for ideas on fixing the
health-care crisis.
Study: U.S. health care not always the
best
Study: U.S. health care not always the
best
05/04/2004 02:01 PMHealth care conundrum
Health care conundrum
06/20/2004 03:53 AMBoston Globe Jun 20 2004 7:13AM GMT
Rule May Let Workers Keep Health
Coverage (AP)
Rule May Let Workers Keep Health
Coverage (AP)
01/01/2005 12:52 AMAP - For U.S. workers who change or lose their jobs, a new rule issued
by the Bush administration just before the end of 2004 could provide
better access to group health plan coverage — in keeping with
changes Congress agreed to eight years ago.
Study: 20M Workers Have No Health
Coverage (AP)
Study: 20M Workers Have No Health
Coverage (AP)
05/05/2004 12:45 PMAP - More than one in five working adults in Texas and five other
Southern and Southwestern states don't have health insurance, a new
study says.
Officials Urge Care on U.S. Intelligence
Reforms (Reuters)
Officials Urge Care on U.S. Intelligence
Reforms (Reuters)
08/17/2004 05:14 PMReuters - Defense Secretary Donald Rumsfeld
urged the U.S. Congress on Tuesday to proceed with great
caution on a proposed overhaul of U.S. intelligence and avoid
putting barriers between military commanders and the agencies
that gather information.
America's Health Care Mess
America's Health Care Mess
07/14/2004 03:30 PMAnother chapter in the health care meltdown:
Sometime in the next few weeks, barring a surprising turn of events,
the state of California will formally approve the merger of two health
insurance giants. An Indiana company called
Anthem will acquire
WellPoint Health Networks, the
Southern California outfit that owns Blue Cross of California, for
about $16.4 billion.
The deal has drawn harsh criticism for many reasons. Not least is the
display of raw greed by the insider executives who stand to collect
somewhere between $200 million and $600 million in payouts after the
buyout is concluded.
More...
XP SP2 puts the squeeze on health care
XP SP2 puts the squeeze on health care
08/10/2004 09:44 PMYou think IBM has problems? How about being a hospital dependent upon
devices that run Windows? They want to have the latest Windows
security patches installed, but how can they when the device
manufacturers haven't certified that their products run...
Health Care IT Czar Speaks
Health Care IT Czar Speaks
05/19/2004 02:52 PMOn the job only a few days, Dr. David Brailer made his first major
speech to attendees of an industry conference entitled "Toward
Electronic Patient Records" in Fort Lauderdale, Fl. this morning.
Kerry Focuses on Health Care (AP)
Kerry Focuses on Health Care (AP)
05/11/2004 02:10 AMAP - Democrat John Kerry is focusing on health care reform in a very
complex environment, one complicated by the furor at home and abroad
over the abuse of Iraqi prisoners by U.S. soldiers.
World Health Care Congress
World Health Care Congress
01/25/2004 11:41 AMI'm in DC in a hotel with a nice view of the J. Edgar Hoover building.
Facilitating a Socialtext Eventspace for the World Health Care
Congress. The World Health Care Congress is the first focused and
inclusive conference to determine...
IBM chalks up two health care wins
IBM chalks up two health care wins
08/18/2004 06:40 PMThe deals with a university medical center and a California health
care provider come two weeks after a win with the Mayo Clinic.
Health care gets more high-tech
Health care gets more high-tech
04/10/2005 12:54 PMChicago Tribune Apr 10 2005 2:26PM GMT
"lgf: Kerry: Lying About Health Care"
"lgf: Kerry: Lying About Health Care"
08/22/2004 04:11 AMBusinessWeek Online: The Hidden Costs of
IT Outsourcing
BusinessWeek Online: The Hidden Costs of
IT Outsourcing
11/03/2003 03:42 PMZDNet Nov 3 2003 2:59PM ET
Study: Health Care Providers to Spend
More on IT
Study: Health Care Providers to Spend
More on IT
06/30/2004 02:46 PMFatal medical errors and stronger government support are driving major
providers' plans to boost IT budgets by more than 10 percent in the
next few years, the Datamonitor report suggests.
VA Health Care Faces Wave of Returning
GIs (AP)
VA Health Care Faces Wave of Returning
GIs (AP)
05/16/2004 08:57 PMAP - More than 20,000 soldiers have sought care from the Veterans
Affairs Department since returning from Iraq and Afghanistan. With
thousands more expected to seek benefits and health care, the VA faces
its biggest challenge since the early 1990s.
HHS names former CareSciences CEO as
health care IT czar
HHS names former CareSciences CEO as
health care IT czar
05/07/2004 04:33 PMThe Department of Health and Human Services also announced the
adoption of new standards that will serve as the bedrock of a national
electronic health record for every American.
Grok Description matches for Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
GrokA matches for Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
