Healthcare Matters

As most of you know, Healthcare Matters is a subsidiary of SpendMatters –the longest running (10 years strong) and most widely read online publication covering all-things-procurement.  In response to SpendMatters readership demand for a publication focused on healthcare, Healthcare Matters was started just a year ago. And thanks to all of you, we’re growing nicely. Steady as she goes.

If you haven’t already, I encourage you to check out SpendMatters. You’ll appreciate the content and while you’re there, click on the links that describe our research capacities (the best in the biz) and our Advisory Services Group.

Enough self-promotion. I wanted to set-up a heartfelt rant by one of the members of our Advisory Services Group, Thomas Kase, who happens to be from Sweden. Not Switzerland, but Sweden. As hard as it is for me to keep my politics separate from government policy (I’m posting everyday), as you’ll see below, Thomas doesn’t have that burden.

Single-Payer Healthcare – It Can Kill You – When the Surgeon Goes to Lunch

When people in the US figure out that I grew up in Sweden, I’m often complimented on how pretty my original homeland is, including the beautiful scenery (which is code for the beautiful women the country is known for). Unfortunately, about half of the people I encounter are confusing Sweden with Switzerland, which is worse than confusing New Mexico with “old” Mexico (which they actually managed to do here in Atlanta during the ’96 Olympics). It’s puzzling.

That aside, what I hear about from the “enlightened throng” is how cool it is that Swedes have “free” schools, “free” healthcare and other (tax-payer-funded) government services. And here’s where I usually lose my patience. After making sure that we’re actually talking about the same country, I point out that a) it’s not really free b) access is highly restrictive c) no one in the US would put up with the quality of care and time it takes to get it and d) there is no recourse for lack of treatment, or outright maltreatment.

Setting aside the price tag discussion – it’s complicated, as the Europeans aren’t known for developing much new medicine and they don’t have American-style malpractice lawsuits and awards to deal with (both keep the costs down) – if we look at access, this is managed under a triage system with patient review boards and enormous (by US standards) wait times.  My brother-in-law, an experienced police officer, whom you’d think would have the best access to healthcare available is stuck inside this “triage glacier”- with wait times for MRI scans, even basic X-ray work not only taking months, but even more months waiting for someone to finally review and analyze the results. The hip surgery he eventually underwent (after waiting in pain for over 5 years) produced a bad outcome, and now he is back in the managed care cycle waiting for a follow up diagnosis. Let me be clear. My brother-in-law is, relatively speaking, a VIP.

Let’s switch gears and just talk about quality of care. I watched all four of my grandparents die prematurely. The quality of care they received –now that I know better (I live in Atlanta) – was the stuff that defines legitimate malpractice. And my disappointment and anger is not baseless, as I have close relations who are in Sweden’s healthcare industry. In fact, I have one relative who is actually the most senior manager in charge of primary healthcare delivery for a region in northern Sweden. Her advice? Run to the ER if is there is anything wrong with you. The rest of our system is a crapshoot.

Take a look at this horror story for a recent example: http://www.thelocal.se/43048/20120906/ – a story where the anesthesiologist and the nurse anesthetist both walk out in the middle of kidney surgery to take lunch!  Just like that, the two of them put down their instruments, wash their hands and leave for lunch, and while they’re gone, the patient dies.

Americans need to appreciate, especially amidst all the consolidation that is going on –along with all the talk of single payer—that major systems like they have in Sweden (there is no such thing as visiting a small clinic) are the primary ingredients of a recipe for long waits and poor quality. Maybe I’m over-reacting, but when two highly trained medical professionals do something as cavalier as walking out on a patient in mid surgery, it is a sign of a system so fundamentally broken and awash in its own protected bureaucracy that I really don’t have any (printable) words to describe it.

Tom told me to go ahead and let it all hang out, so I don’t mind saying that it is my sincere hope that we don’t clamor down this path here in the US. Sure, I expect to hear from some of you (please comment) that I’m all wet and that “single payer” doesn’t necessarily equate to “certain disaster,” but I will say this: If they can’t make it work in Sweden – the equivalent of a single, wealthy state here in America—then I’m hard pressed to comprehend how it can work here in the United States –without a dramatic decline in access and quality.

—Thomas Kase