Henry the VIII’s ghost. The Catholic Church, the Reformation and Health Reform
Hospitals have gone from being utilitarian buildings that housed the acutely sick for a short period of their life, into a billion dollar empires full of powerful vested interest groups, fighting over 10 to 20 % of their countries Gross Domestic Products.
Instead of families caring for their elderly relatives in the last years of their lives, the elderly are now ferried into large modern Emergency departments by a fleet of ambulances, then packed onto hospital trolleys like sardines. Do they live longer or experience a better quality of life? I doubt it. Do they suffer more risk of errors? Absolutely. Homeless people, psychiatric patients and people with minor cuts and bruises all flood into modern Emergency departments. Do they end up with unnecessary tests and treatments? Yes. Do they experience better long-term outcomes? I doubt it. “Every dollar wasted is a dollar earned by someone” remarked an experienced Australian health commentator.
Few people connect hospitals with unnecessary tests and treatments, unnecessary errors and deliberate profit-making. The trifecta of medicine, science and technology seem to be an all seeing, all knowing God.
It’s a con job. Over-servicing is an epidemic, particularly in the lucrative ‘medicine for money’ private sector. Hospital errors kill and main nine times more people than the national road toll. The difference is the road toll is public. Hospital errors are hidden by an army of lawyers and ‘commercial in confidence’ laws.
The modern day health industry resembles the Catholic Churches in the Middle Ages. All powerful, secretive and very, very wealthy. But all empires eventually fall.
Who in the Catholic Church would have thought that an arrogant, willful English king who couldn’t produce a male hair would eventually break the power of Rome? The powerful Catholic Church said “no divorce” to Henry VIII when he wanted to remarry and raise a male child to carry on his family line. Henry said “your sacked” and went on to destroy the Catholic monasteries, sell off their wealthy assets, kill their Archbishops and marry 5 wives. It didn’t give him a male heir. But it did teach the most powerful institution in the Western world a sharp lesson. No one can have all the money and all the power, for ever. And be wary of the power of Kings.
Fast forward to the 21st century. Health spending has risen faster than economic growth over the past 20 years in OECD countries. Currently, health spending is around 10% of GDP in most OECD countries and around 18% in the private USA system. Up to one-third of health budgets in all Western countries is reported to be wasted on fraud, waste and unnecessary tests. 4 Corners recently ran a program called Wasted, Norman Swan explained that 150 billion a year is wasted in Australia. And still, the powerful health industry refuses to reform it’s wasteful and arrogant ways
Who in the Western healthcare industry would seriously think that a taxi sharing service could break their empire?
RockHealth has published a story titled ‘why there is no Uber for healthcare. The title is misleading. It should read ‘How Uber can deliver healthcare, to your home, when it suits you, at a fraction of the cost’.
A fragmented array of home health services are now delivering everything from dentistry to medications to people’s home. They charge a fraction of the price of traditional, wasteful, over servicing hospitals. Uber has partnered with these groups to coordinate and deliver their services. This takes the power away from power hungry overpriced hospitals.
As RockHealth observes, funding in the USA for on-demand healthcare has been steadily growing. It now represents over 7% of total digital health funding, up from less than 2% in 2011.
Several demographic changes are encouraging this change. As more women move into medicine, the push for family-friendly hours and part medicine grows. Patients are used to dialing up fast food, banking and transport on their smartphone, so why not medical services? High-density inner cities allows home services to be cost effective. And blue tooth plus the internet enabled smartphones equals 24/7 tracking and communication tools.
Problems include the information silos that lock up patients records into local hospitals or clinics, and patients inability to claim home health services on government or private insurance. They have to pay the full cost up front. But that shows them how over-priced both government funded, and privately funded health systems are.
The reformation is coming. And from an unlikely source. The wealthy, powerful and arrogant health industry should take a lesson from history. They can’t have all the money, all the power and live on traditional values. And the ‘Kings’ of Silicone Vally and billion-dollar startups are flexing their muscles.
Health reform could be driving to your home, via an Uber car in the next decade. And money hungry, poorly performing hospitals could become relics of a foolish, outdated empire.