From an article in Time…

If there is an ideal out there, Baucus says, it can be seen in the kind of medicine already being practiced by Kaiser Permanente, the Mayo Clinic, Intermountain Healthcare and Geisinger Health System, which manage to hold down costs and get better results. Their operations have fostered closer teamwork among care providers. Also important will be electronic record-keeping that saves time and avoids errors, and comparative-effectiveness research that gives doctors and patients a better sense of which treatments work best. And a reformed health-care system would put more emphasis on preventive care and managing such chronic conditions as asthma, heart disease and diabetes that now account for 75 cents out of every medical dollar spent.

The Five Big Health-Care Dilemmas – TIME

Today healthcare providers are reimbursed based on the quantity  and volume of services they provide with little emphasis on the quality of the outcome. Hence a patient may undergo the same procedure multiple times with little or no change in outcome.  Instead of finding opportunities for early intervention and prevention the onus somehow seems to be towards letting conditions become chronic resulting in costly and avoidable treatments. Ironically, it is financially advantageous to a hospital to have a patient come in several times for a procedure or surgery rather than get a single effective procedure and get discharged. Add to the fact that due to inefficient systems, patients are often times recommended duplicate procedures and tests that simply adds to the final costs but does not contribute to favorable outcomes.

Customers shopping for products are often allowed to test them before they buy and return the same if they aren’t fully satisfied with it.  Most products are covered by warranties and guarantees for quality and performance. Why not apply the same rules to health services rendered by hospitals? Why as a consumer of services, a patient is not allowed to pre-negotiate a price for a procedure or a service?  Also why don’t hospitals provide a guarantee/warranty for the procedure or service they perform? Wouldn’t market dynamics settle the price at a level people are willing to pay?

In a Supply chain scenario the objective is always to minimize the number of links (bottlenecks/middlemen) in the distribution chain to minimize costs and increase effectiveness. Likewise, why aren’t we able to apply the same rules to healthcare services, where a bulk of the costs are due to the operational inefficiencies of payers who also act as middlemen in determining the procedure or treatment a patient has to undergo?

That being said, some hospitals are making inroads into guaranteed services, which means that within a given guarantee period if a patient returns for the same treatment, then the same would be provided free of cost. At a minimum, I think such guarantees should be mandatorily provided for implants and prosthetic devices.