I think that we can all agree that medical costs are growing faster than almost anything else. The solution is not throwing more money at the problem. If not, then what is? We have to totally rethink exactly how we provide medical service in the USA. In almost every other area of economics, we have seen a gradual, but significant increase in efficiency that has lower cost or kept them even. This has not happened with medical cost. Did you ever wonder why? First, we need to look at exactly why and how we have made significant improvements in efficiency in other areas. That is the point of this blog.
In almost all other areas, knowledge and skill have a "multiplication" factor. What do I mean by a "multiplication" factor? Take an engineer who owns a small company that builds some very complex product. The engineer does not build all these complex products, but he does know how to design them and exactly how to build them. He knows all the processes in detail and has designed many of the tools and jigs that are required to build the product. The people who actually assemble the parts are "not" skilled like the engineer. What the engineer has done is to "multiply" his skill, education and knowledge and thus produce much more than he could have produced had he done all the work by him or her self. This is what is missing from how we provide medical services.
In the case of medicine, we handle it as if all the doctors are master artists or musicians. In the case of an artist, they have to do all the actual work all by themselves. They can not multiply their work by showing others how to make the drawing so that they can sign it at the bottom. Think of all the things that doctors do? For some reason we do not allow doctors to delegate individual jobs to lower skilled people. Remember when the big thing in the news was that people from companies who designed and built artificial joints were in the operating rooms installing the joints while the doctors just watched. What was wrong with letting the specialist do the job if they could do it better than the doctor? I am a good welder and know all about the technology related to welding, but I prefer to hire people who have less education, but who are more skilled in actual welding. That is the way it is done every place else, but not in medicine. In a few places, we see nurse practitioners, but this is about 100 years too late.
If you look at what doctors do now, you would have to agree that at least 75% of what they do could be done by someone with a lot less education and thus at a lower cost. Who do you think does all the blood tests? Those people are not doctors. How about reading x-ray? These are some of the highest paid doctors, but it could be done by a person any place in the world with little more than a high school education with some special knowledge just in the area of x-rays and biology. Who is preventing multiplication in our medical system? Is it lawyers or is it the old doctors who have made the big investment and now do not want others to take some kind of short cut? It is both. If I had a cut, I would feel just fine asking my neighbor, who is a veterinarian, to stitch it up rather than going to an expensive regular doctor. How about you? Look at the poor druggist. He goes to school to learn about all kinds of medicine, but ends up just counting pills. Is that a waste or what? He could multiply his knowledge if we would just get off his back with regulations.
We have this problem at all levels. How about your dentist? Why can't a hygienist come to my house like a massage therapist and clean my teeth? Do you think it would be cheaper if they could? Under the supervision of a dentist, do you think that a smart high school graduate could fill your teeth or make false teeth? You don't even know who makes your false teeth. Many are made in Mexico and mailed back to the dentist here. It is happening, but it is not enough. We need to wise up and figure out ways that we can multiply skill and knowledge related to medical like we do in every other area of our economy. Bankers do it. Do you think the clerks actually run the bank?
What we need to do is the multiply skill and knowledge at all levels of medical service. I feel that this is the only way that we are going to get the cost down while not risking too much decline in quality. If you can't afford some kind of medical service, quality doesn't mean anything and that is the direction that we are going with the way we are handling medical services. I know that we all want to drive brand new Cadillacs, but you know that we all can't afford them. It is the same way with medical services. Wise up and think for yourself.
