Why U.S. healthcare is like my favorite vegan restaurant

I am a wannabe vegan, which means that I'm an omnivore with guilt. So, there's a vegan place in town that I like but I tend to arrive within an hour or so of the closing time. Inevitably, they are out of the dish I want. Moreover, they are typically out of many, many dishes. Since they are located across the street from a large grocery store I've always wondered why they just don't go to the grocery store when they run out of ingredients.

After experiencing this phenomenon many times I screwed up my courage to ask my server why they run out of so many dishes when a grocer is across the street - why don't they just go pick up some more spinach?

She told me, "no one has ever asked that question before?" I responded, "by no one do you mean no customers - or no employees?" She said, "neither". Really? No employee has ever said, "We're a vegan place and we're out of greens, I'll be back in a few with more greens." Guess not.

But, then I thought more about it and I realized that this is no different than U.S. healthcare. What's remarkable about U.S. healthcare are the questions that are never asked. You would think that in an industry infamous for waste, poor service and excessive costs, there would a be question-asking feeding frenzy. Nothing is further from reality. Healthcare professionals and executives don't ask that questions that make each other squirm. Plus there's simply a long list of forbidden questions.

Let's kick off the question-asking party right here, right now:

  • What are all things we do that add no value? Can we strip this waste out now?

  • What if we really paid for wellness rather than sickness?

  • What if we paid primary care NPs more than surgeons?

  • Why do doctors get paid what they are paid? Are they worth it? If not, what would make them worth it? Why don't we tell them straight up?

  • Why do we pay more for the same care delivered in hospitals/ERs than when delivered in a neighborhood clinic?

What if someone was offended? What if a job was eliminated? What if a regulation that we hold dear is part of the problem?

Oh no!

Can't wait till my next visit to the vegan place.....

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