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August 21, 2008

The War on Healthcare

Do you work in health care in the USA? If so then you either have a big opportunity - or you are part of the cause of a very big problem. 

A colleague of mine provides analytical services to this marketplace. In particular he helps them to highlight the root cause of process and system deviations to prevent reccurrance, or to intervene before they reach a critical stage. 

At first I thought it was a nothing crusade. I didn't think that the market would support it, and I didn't think that the health care system would be in need of such an analytical process. Particularly not with the abundance of brilliant people working in that industry.

How wrong I was. (Not unusual) My colleague has gone on to build this industry into one of the pillars of his business, basing a large percentage of his annual revenues on working there. For someone with a background in the engineering field this is a phenomenal piece of Blue Ocean thinking. 

Just recently I have been observing Tom Peters in his latest crusade - the war against the under managed health care system of the USA.

Here is part of the report card he posted on his web over at (He also has a lot of presentations there if you are interested in downloading them.)

Tom Peters/The U.S. Healthcare14

  • U.S. Life expectancy rank: #45.
  • WHO, overall American healthcare system performance: #37 (#1 in cost).
  • Access: Denied to 10s of millions un/underinsured.
  • Unnecessary annual health-system deaths: 200,000-400,000 or more.*
  • Performance/top med centers: Problematic re quality of care and follow-up.*
  • Over-treatment (meds, tests, procedures): Pandemic.*
  • Use of hard evidence in medical decision-making: Spotty at best.*
  • Collection of evidence based on reported treatment errors: Low.*
  • Use of S.O.P.s in treatment regimes: Spotty.*
  • Incentives for appropriate care: Low.*
  • Incentives for inappropriate care: High.*
  • Emphasis on prevention and wellness: Low.*
  • Emphasis on chronic-care: Low.*
  • State-of-the-art IS/IT: Rare.*
 However I have to confess that I have only a very limited experience of the USA health care system, and for me it worked wonderfully well. I was in and out within two days, as a foreigner, and they treated me with full respect and full care as far as I can recall.

Now the UK is another matter totally...

Myself and my wife had cause to use this system extensively over a four year period, and we were disgusted. Dirty, rude, unhygienic, lazy, incompetent and ... did I mention rude? 

For years I have been a supporter of nationalized health care... not anymore. You do not want to evolve into the UK; not ever. (In just about any area actually.)

Remember... this is the country that gave the world Harold Shipman. Doctor, english gent...largest mass murder in history. 

Here are some headlines from prominent English newspapers in just the past two years. A country where medicine is nationalized, where you cannot sue for fair compensation by way of malpractice, a country where the taxpayer pays the doctors salaries (and ends up defrauded to the tune of billions of incompetently spent government funds), and where you cannot choose your own doctor. (You must go to the doctor in your area.)

And don't think you can go directly to a specialist... Oh no. You are too unimportant to wast the time of people like that. Only doctors in the NHS can determine if you should be referred to a Specialist or not.

Medicine by budget, you cannot get the drugs you need, even if you offer to pay for them yourself, you cannot see a dentist - the NHS has made the UK the land that modern dentistry forgot.

Its a socialist nightmare...

  • Heart patients dying due to poor hospital care, says report - Sarah Boseley, June 8, 2008 [Guardian Unlimited]
  • NHS dentistry loses almost a million patients after new dentists' contract - David Rose, June 6, 2008 [The Times]
  • Private healthcare managers could be sent to turn round failing NHS hospitals - Philip Webster, Political Editor, and David Rose, June 4, 2008 [The Times]
  • Cancer patients ‘betrayed’ by NHS - Sarah-Kate Templeton, June 1, 2008 [The Times]
  • Pensioner, 76, forced to pull out own teeth after 12 NHS dentists refuse to treat her - Olinka Koster, March 26, 2008 [Daily Mail(UK)]
  • Lung patients 'condemned to death as NHS withdraws their too expensive drugs' - Jenny Hope, March 24, 2008 [Daily Mail(UK)]
  • Women in labour turned away by maternity units - John Carvel, March 21, 2008 [Guardian Unlimited]
  • Health inequality has got worse under Labour, says government report - Andrew Sparrow, March 13, 2008 [Guardian Unlimited]
  • Angry GPs reluctantly accept plan for weekend and evening surgeries - John Carvel, March 7, 2008 [Guardian Unlimited]
  • NHS chiefs tell grandmother, 61, she's 'too old' for £5,000 life-saving heart surgery - Chris Brooke, February 28, 2008 [Daily Mail(UK)]
  • Patient 'removed' from waiting list to meet target - January 31, 2008 [The Scotsman]
  • One in eight patients waiting over a year for treatment, admits minister - John Carvel, June 8, 2007 [Guardian Unlimited]
  • One in six trusts is still putting patients on mixed-sex wards - Daniel Martin, May 10, 2007 [Daily Mail(UK)
  • Smokers and the obese banned from UK hospitals - May 2, 2007 [Healthcare News]
  • Cancer patients told life-prolonging treatment is too expensive for NHS - Lyndsay Moss, February 13, 2007 [The Scotsman]
  • UK health service "harms 10 percent of patients" - Kate Kelland, July 7, 2006 [Reuters]
  • 5,000 elderly 'killed each year' by lack of care beds - June 26, 2006 [Telegraph UK]
I could go on. I have hundreds of these unfortunately.

My point is this. The statistics don't always tell the correct story. I am sure that the USA healthcare system has its problems and yes it desperately needs to be fixed. But socialized health care programs around the world have their own fair share of problems also. And this should not be  overlooked. 

I would be fascinated by a Tom Peters style inquiry into the UK's woefully pathetic health care record. Particularly those around hygiene, bedside manner and competence. 

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