Friday, November 8, 2019

Looking in Our Back Yards for Healthcare Waste

Dr. Marty Makary was the keynote speaker at the opening session of the Food and Nutrition Conference and Expo 2019.  One of my goals after attending the educational sessions was to read current books (even those written by authors with a different perspective). While I worked in Healthcare for much of my 40 year career, I was a front-line manager who had nothing to do with patient billing. I, like all hospital employees, lived within the contracts and often changing policies set forth by administration. I certainly did not know enough to look at it through Dr. Makarys' perspective.

I knew that the Community Benefit report we kept daily by recording and costing foods donated to Salvation Army helped the hospital maintain its tax exempt status. Now, 5 years after retiring and 3 years after the cafeterias closing, the hospital system is opening clinics and buying hospitals everywhere. Has the tax exempt status changed?

Then there's Group Purchasing Organizations:  Some 80% of our dietary purchases were through Premier- one of the largest GPOs. Dr. Makary notes that GPOs got paid over 1/2 billion in "pay to play" fees in 2017. Remember the Safe Harbor Law we were required to know in the computer based learning programs ? Seems that in 1987 Congress allowed the GPO and Pharmacy Based Managers to receive kickbacks that inflate health care costs. This has never been repealed. Were the rebates we received as credits in our food budgets actually "kickbacks"? 

Other subjects in the book that touched home included his summation that the Workplace Wellness Industry is one run amok. I do remember taking an on-line course on blood pressure in hopes of getting a health insurance discount-and, yes-I felt I knew much more about diet and blood pressure than the course content. Were the annual wellness questionnaires we were encouraged to take an added "cost"?

"The Price We Pay" book only reaffirms the financial fear most of us have when it comes to health care. It's not the insurance, employer or the government paying for it-it's all of us. And we are being gouged. Heaven forbid we ever have to go "out of network" or be air lifted the the Emergency Room.

Dr. Makary ends with a few suggestions:
1) Know the price before getting a medical service.
2) Use on-line discounts (GoodRx,, Blink Health) for pharmaceuticals.

And to those working in Health Care-look in your own back yard to find waste.

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