The Healthcare Chopping Block: Spend Management’s Extremities

Every so often, a piece of news comes out that we can't NOT debate in our office. This story out of Greece, which made the Internet rounds yesterday, is a quintessential example of absurdity worthy of debate. The headline just about tells it all: "Greek Health System Opts for Amputation as Money-Saver." According to the details of the story, one of Greece's "most respected newspapers" recently "reported that the nation's largest government health insurance provider would no longer pay for special footwear for diabetes patients. Amputation is cheaper, says the Benefits Division of the state insurance provider."

Now, regardless of whether or not this story proves false (or whether the insurer changes its position after public outrage), it raises a number of fascinating questions, not the least of which is whether such behavior really does save money if we examine total cost of ownership (e.g., in a society with socialized healthcare, should the government pay more upfront to have more productive citizens, tax contributing citizens, versus, just well, hacking off costs on a per-unit basis). I suppose in Greece the "tax contributing" citizens piece may not be the best total cost argument in favor of saving money (those two words seemingly don't go together in that society) by not lopping off limbs. But in most tax-paying cultures, it's a worthy question.

Besides, Greece may find that it loses truly unique musical protégés by engaging in such behavior. In all seriousness, the question of spending vs. not spending for potentially life-saving treatments (e.g., administering new cancer treatments) is one that all private and public sector insurers and providers across the globe need to make all the time. These are life and death decisions. I suspect in the US specifically that if we were able to cut the spending fat, physician preference and wasted savings aggregation potential out of the healthcare cost savings equation, that we'd find ourselves with the potential to improve patient outcomes without increasing overall costs.

Jason Busch

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