Law of supply and demand rules even in health care

It’s not easy to make health care even more expensive

I hurt my back launching my sailboat last summer. Since it wasn’t getting better like it normally does, I decided to visit my back doctor. He was over an hour late for my appointment, and he was not in a good mood. Obamacare had him quite upset.

“I’m supposed to counsel you to quit smoking.”

“I don’t smoke.”

“That doesn’t make any difference.”

“Huh? You’re a neurologist and a back surgeon. Smoking has nothing to do with your expertise or specialties.”

“That doesn’t make any difference either. I’m also supposed to ask you if you own a gun.”

“What does that have to do with anything?”

I kind of chalked this up to a bad day for the doctor and forgot about it. Then I went for my annual physical a few weeks later and had a similar conversation with my primary care doctor.

And if two data points weren’t enough, I had the same conversation with another doctor a few weeks after that.

It seems this is far from being the law’s only unreasonable requirement. I’m told it’s full of them.

Obamacare is supposed to lower the cost of health care. Isn’t requiring physicians to provide counseling outside their specialties, whether the patient needs it or not, going to drive the cost up instead of down? This doctor was always on time before he was given all the extra stuff to do.

An awful lot has been written about this law and its celebrated website in recent weeks. When people do manage to get quotes, there’s an awful lot of sticker shock out there, and this may be part of the reason.

At a recent event, I found myself sitting next to one of our state senators. I had sat with her at another event several years ago where I learned she was a proponent of the new health care law. I asked her how she felt about it now.

She said we have to remember the real purpose is improving health care and making it affordable for everyone. She said smart physicians would ignore the unreasonable parts of the law.

I always thought laws were meant to be followed. Do we expect professionals to risk their medical licenses to deliver “reasonable” health care? (It wouldn’t be fair to name the senator, as she wasn’t expecting me to quote her. I didn’t think of writing about this until a few weeks later.)

Eliminate the causes

She asked how I would fix health care.

I would use the same approach I use to troubleshoot and improve any process. The first question is what are the problems? What’s causing them?

Shouldn’t we begin by removing the causes that make people sick? Why is our government still subsidizing tobacco farmers? Why do we allow trans fats, preservatives, carcinogens and other poisons in our food supply?

Why are we feeding kids pizza, nachos and other unhealthy foods in our schools? Aren’t we helping them to form some very unhealthy eating habits? Childhood obesity is a major problem, and obesity causes a lot of illnesses that are very expensive to treat.

I think it’s great that we prevent manufacturers from using asbestos, lead paint and other things that are bad for us. Why aren’t we forcing food processors to not put poisons in the things we eat?

If we don’t make so many people sick, we will have more than adequate medical resources to take care of the unavoidable illnesses, and the care will be much cheaper. Yes, Economics 101, the law of supply and demand, rules even in health care.

Health insurance is so expensive because medical care is so costly, and all these poisons to which we are exposed ensure too many of us will need it.

Interestingly, many hospitals are using the same performance improvement techniques to improve the quality and the outcomes of their processes, yet the greatest opportunity is using these techniques on the system as a whole.

What about your company? Our government doesn’t have a monopoly on bad policies and procedures. It’s always easier to see the problems in someone else’s operations than it is in our own.

Do you or your policies require people to do things that are completely irrelevant to the outcomes you want? Do you try to manage and control your problems rather than finding and eliminating their causes?

Whether you’re streamlining health care or your operations, that’s how it’s done. Like it or not, we have to squeeze more inefficiencies out of our operations to pay for the inefficiencies in the “health insurance” we’re buying.

Ronald J. Bourque, a consultant and speaker from Windham, has had engagements throughout the United States, Europe and Asia. He can be reached at 603-898-1871 or

Categories: Business Advice, Workplace Advice