Why We Can't Have Improved Healthcare Cost, Access, and Quality

July 17, 2014
James Doulgeris

Achieving improved cost, access, and quality of healthcare is an elusive goal for good reason. Like a balloon animal, squeezing one part always affects another.

Aaron Carroll, a professor of pediatrics at Indiana University School of Medicine and blogger for The Incidental Economist, explains why he believes the Affordable Care Act is proving to be more expensive in his July 14, 2014, column for The New York Times:

"One of the most important facts about healthcare overhaul, and one that is often overlooked, is that all changes to the healthcare system involve trade-offs among access, quality, and cost," Carroll writes. "You can improve one of these – maybe two – but it will almost always result in some other aspect getting worse."

U.S. healthcare is a highly regulated, closed system, and Carroll is absolutely correct. Like a balloon animal, squeezing or inflating one part always affects another.

It is simple physics. Inflating access inflates cost while deflating quality.

Artificially regulating the system’s attempts to balance itself only makes things worse, and the more regulation applied, the more regulation needed.

Every move that they make makes at least one thing worse, and that pretty much sums things up with HHS, CMS, and the reform law.

Having learned from repeated personal experience, it takes expertise to make something more complex, but, it takes inspiration to make it "more simple."

Being intellectually and physically lazy, I prefer inspiration.

So, here it is. The problem is not the complex dynamics of the cause and effect of the three primary fundamentals of the healthcare system: access, cost, and quality.

The problem is that it is a closed system.

Open it up to, and invest in, the innovation, inspiration, and leadership that built this country. Regulate it to keep the charlatans, carpetbaggers, and swindlers at bay, and, let imagination, inspiration and entrepreneurship have their day.

The free market with its winners and losers may not have the greatest political optics (how things are perceived by voters), but, an open, competitive system will immediately strive to provide the best quality at the best cost to the most people without one costing the other.

The physics of both systems are immutable, and, the closed system created this mess. Government regulation sealed it tight and politics over pressurized it to the point of stressing the entire economy.

Avoiding the crashing and burning, the drama, investigations, and politics with some common sense and leadership is less entertaining, but, that’s what Candy Crush is for.

Call me a dreamer.