walkitout (walkitout) wrote,

Healthcare Costs

I had a nice, long conversation with my sister (a nurse) about health care. She's pessimistic about the probable utility of Medicare in her future. She doesn't not think it will be legislated away, just that reimbursement rates will become so pitiful that anyone using that to access health care will be completely screwed. I'll save my thoughts on that for a later post.

She would like to see us save money by not doing treatments that do extend life, but at massive cost to quality of life. I think that's way too controversial for me to want to take on. I mostly want to do a bunch of studies to decide which really expensive things _don't_ extend life, so we can quit doing them and improve outcomes (no benefit from doing it plus risk means stopping makes it all better).

Long before we get to that point, however, I would like to point something out about infection control. Hospital-acquired infections are nasty, expensive and sometimes lethal. That we know. What may be less obvious is how a hospital-acquired infection can become a person-on-a-heart-transplant-list. I, personally, have seen that happen. Resolving the infection and a slow recovery process means that person came back off the heart transplant list (yay, happy), and a better mix of blood pressure and other meds means they're mostly okay now. But it could have gone another direction that would have been fantastically more expensive.

Putting a stop to hospital-acquired infections is a really high priority right now, for a lot of reasons. But one of the less expected side effects might be massive savings on really big other interventions that are a knock-on effect of the infection but that we don't _realize_ are knock-on effects.
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