Rational Monetary Incentives

The Golden Rule - he who has the gold makes the rules. The laws of supply and demand unfortunately do not address systems thinking on a larger scale. An economic policy that drives cash flow is in direct conflict with forces that optimize efficient systems in any industry. After all, systems thinking demands that all industries are linked which has brought about recent discoveries in the discipline of supply chain management.

Rational monetary incentives in systems thinking only add fuel to the fire. The latest economic stimulus in healthcare is no exception. One example proposed by MedPAC Chair, Glenn Hackbarth, is to compensate doctors based on readmission rates.

To repackage IT, among execs, there is speculation around how real-time clinical data will translate to process improvement, better described by Kaiser Exec, George Halvorson, as "sustaining a culture of ongoing improvement". Primary care will take a leading role in limiting trips to a traditional facility - now home or office-based. With cost overruns, industry critics outside healthcare like Eliyahu Goldratt realize the self-destructive cycle IT companies experience during periods of corporate "realignment" to commoditize their offerings.

For the doctor's bill, go line by line to understand that surgical procedure. Understand it now? Right. A doctor friend of mine talked about a procedure his wife had for her ear. $20 per ear drop to pack it. Yep, they were even the prescribed drops in the correct ear. Opinions driving these costs are rampant. This doctor claims that charging a lot for very simple prep work makes up for the much lower fees to make a diagnosis or to start cutting. With his seniority in mind, I did not question his personal involvement in these matters, but based his opinion on research, or at least second-hand info.

In systems thinking, what can we take away from any system to optimize performance? In systems thinking, less is more.