Guys, listen: on my recent daily read through of articles on healthcare quality, I ran across one that made me want to share.
It all started with a quote that “Cost is the number one threat to quality in the United States…”
Before I jump in and comment on the quote, just a few things. First, the person who gave the quote is really very excellent and quite intelligent. Second, sometimes what we say in the context of an interview doesn’t exactly come across correctly once the article is written out and distributed out there for all of us to see.
For instance, I’ve done interviews for USA Today and several other publications…all with excellent reporters attached to each article. No matter how good they are, sometimes they select something for the final article that doesn’t really make sense out of the context of the interview.
Maybe some of that is what happened to Peggy O’Kane with her quote I describe above. (Click the link at the bottom of the entry for the full article including her quote.)
Now, allowing for that: the idea that cost is the number one threat to quality in the United States is, to my mind, a cart-before-horse type statement.
It’s way off the mark. Here’s why:
- Even low level quality improvement projects in healthcare routinely recover $300,000+ from the Cost of Poor Quality (COPQ).
- US healthcare spends around 14% of its GDP to achieve a median life expectancy that is usually ranked worse than 20th in the world.
If these facts weren’t enough, here’s just a sample off the top of my head that highlights how much cost is incurred by a healthcare lab owing to poor quality:
Each answer option in Ms. Dawson’s question is a well-known truism in quality improvement circles. (She asks which one best highlights long term cost savings to be had via investment in quality.) But look at choice D–that demonstrates how costs for the lab are increased by Cost of Poor Quality (or COPQ). Reducing that COPQ would allow for improved profits to the hospital. A poor level of quality is a great deal of the REASON for higher costs…and that level can be improved.
That’s the whole point here: given the performance of our system overall (and, by the way, our health system can do some awesome things) it is exactly backwards to claim that cost is a threat to quality. In fact, it’s the other way around.
For all you healthcare colleagues out there, let me say it this way: you wouldn’t say a patient’s abdominal pain is a threat to their perforated gastric ulcer. So don’t blame the symptom that is high healthcare costs on the real issue: healthcare system quality. It’s just plain backwards.
Cost is the number 1 threat to quality in the United States,” said Peggy O’Kane, founder and President of the National Committee for Quality Assurance. “It hurts the ability of doctors to do a good job. We have a lot of high deductibles that stand in the way of getting the kind of primary care and chronic disease management care that people need.