I have spent nearly 13 years inside healthcare. By the way, when I use the term health care (two words) I am referring to the medical side and when I use healthcare I refer to the business which includes vendors of supplies, technology and services as well as the non-medical aspects of clinics and hospitals. Q1 has been asked repeatedly but never in a national forum such as Time. The response is and has been the same. You get shuffling, arm-waving and redirection. What you never get is an answer.
In a way this is similar to recent revelations about certain banks who have laundered drug money, facilitated illegal transactions in violation of US and UN sanctions and provided consulting services to sanctioned nations on how to circumvent sanctions. Caught with blood on their hands, they are unrepentant and simply threaten dire consequences if they are prosecuted or held to account.
"We're working for the good of our patients!" is part of every response from healthcare. In fact this shibboleth is a mutation of both the Hippocratic Oath and the motto of the Mayo Clinic. In a discussion during the formative years of the Mayo Clinic there was discussion about which of two paths should be taken and the response from one of the brothers Mayo was, "The needs of the patient are the only needs to be considered."
This is clearly in alignment with the Hippocratic Oath and the practice of Medicine. Questions and answers are clear cut when the patient in the exam room or on the operating table is in focus. When "the Patient" becomes "our patients" the focus is no longer so clear and both questions and answers get fluffy. Healthcare has been allowed to cover itself with the very porous shield of "our patients" for far too long.
There is massive collusion in every aspect of the healthcare vertical. Prices everywhere are based on what the customer will pay and cost never enters into the equation. No one is interested in cost including the payer with one exception--Medicare. In fairness, the fear of litigation drives up costs but since costs are not the basis of price in healthcare except as a very insignificant seed around which is wrapped layers and layers of dough, this fear can hardly be used as justification.
Lowest price is recognized as a negative since customers immediately wonder what they're NOT getting. Are the manufacturing processes not controlled? Is contamination going to be a problem? Utility and usability, even applicability are given lip service in the buying process but the business always goes to customer service which, in healthcare, is frequently in the form of high-priced consulting services anchored by high-priced account executives. I have personally participated in several purchasing efforts which were identical to one another in terms of process and result. The process, based on carefully researched industry best practice (strangely enough, defined by the vendors), includes
- forming a team of stakeholders
- creating an RFP (Request for Proposal)
- researching likely vendors (you can't just broadcast an RFP and wait for responses)
- submitting your RFP to the list of selected vendors
- sitting through demonstrations and presentations by each vendor (none ever declines to participate)
- comparing all of the proposals to that of our "favorite" vendor
- awarding the contract to the favorite
- signing an ancillary contract for "support services" whose cost, though large, is never included with the purchase price.
- forming an implementation team
- "partnering" with the vendor's implementation specialists on a multiple-month (or year) project to put the system of product into service for "our patients"
This is why it looks as though no one ever asks Q1. The only entity that could ask and demand a real answer is the government and that isn't going to be allowed.
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