About Suicide Economics

Thinking the Unthinkable

By Dr. David Edward Marcinko; MBA CMP™

Staff Reporters

According to the Wall Street Journal, November 5, 2008, voters in Washington State just passed an initiative legalizing physician-assisted suicide.

Passed by a Margin of 3:2

A state measure known as “Initiative 1000” passed by a margin of 59% to 41%, making it legal for doctors to prescribe a lethal dose of medication for patients with less than six months to live. The law is packed with provisions intended to limit the practice. For example, patients must make two separate requests, orally and in writing, more than two weeks apart; must be of sound mind and not suffering from depression; and must have their request approved by two separate doctors.

The Oregon Experience

However, doctors are not allowed to administer the lethal dose. In Oregon, the only other state with a similar law, some 341 patients have committed physician-assisted suicide in the 11 years the law has been in effect.

Economics of Assisted Suicide

Decades ago, the economist John Maynard Keynes’s suggested that saving may be a private virtue, but a public vice. According to Keynes, a community that seeks to increase its rate of saving would end up impoverishing itself and actually saving less. But, the community that increases its consumption at the expense of saving would end-up being richer and saving more. This proposition is frequently stated in macroeconomics textbooks as the “paradox of thrift.”

Assessment

The average lifespan, in the US, was about 67 years when Medicare was passed. It is about 78 today. Rising healthcare costs are led by this longevity. In other words, death financially supports survivors.  

Conclusion

And so, is “Initiative 1000” a human socio-economic metaphor for the “thrift-paradox”; please opine and comment?

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Health Economists and the Economy

“The Not-So-Dismal Science”

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Fenway Park Dr. Marcinko

Economics was labeled the “dismal-science” by Thomas Carlyle a century ago. Since then, its tradition of negativity carries into the present recessionary environment. As the corporate credit and home mortgage crisis escalates, the financial and pharmaceutical industries implode and the population ages, hospitals are shuttered, re-sized or merely struggle onward with trepidation. And, daily, the media focuses on the increasing number of our citizens without health insurance.

To “Afflict the Comfortable and Comfort the Afflicted”

Such media coverage is expected entering into a general economic contraction, recession and/or depression for the healthcare sector, and economy as a whole.

But, in their zeal to “afflict the comfortable and comfort the afflicted”, the media victimizes the for-profit class, while it champions public hospitals, not-for-profit clinics and nanny-state medical care. The news is pre-occupied with calamity even when the health sector is fundamentally strong.

A Print Guide for us All

OK, premium print guides like Healthcare Organizations [Financial Management Strategies] know that bad news draws more subscribers than good news.

When all is well, physicians, executives and administrators are not keen on constructive change. There are also fewer reasons to log-on to this Medical Executive-Post blog. It’s all a matter of perspective!

Q: But, why is the media’s take on economic issues so important?

A: Because it has significant impact on how patients view the entire healthcare industrial complex! It influences how doctors, insurers and politicians adjust their own lobbying and legislative initiatives. And, it governs how CFOs invest in capital expenditures, as well.

Historical Review

Yet, media glare on our industry is not new. It began in 1963 with the article “Uncertainty and the Welfare of Medical Care,” and again in 1972 when Nobel Laureate Kenneth J. Arrow PhD shocked academe’ by identifying health-economics as a separate and distinct field. He codified seemingly disparate insurance, econometric, statistical, business and financial management principles for us all. And, he argued that the marketplace was incapable of insuring against the uncertainties we face in the healthcare arena.

Another View

Of course, the opposing viewpoint argues that, without the existence of a competitive market, individuals lose their freedom to choose, or are allowed to consume medical care for “free.” Therefore, the marketplace cannot learn what an individual values most.  Nevertheless, to informed executives and our readers and subscribers, Arrow served as progenitor to the modern strategic health advisory era. In 2004, he was awarded the National Medal of Science for his innovative views.

Economy as Excuse for Self-Pity

Unfortunately for some hospitals, disinformation and exaggeration about health economics is just the excuse needed for self-pity, or to reduce or cease operations. “It’s not our fault, we can’t compete in a free-market economy and our patient satisfaction rates are falling. The malaise is sapping our morale”; etc, and ad nausea 

A More Positive Approach

For others, there is the more positive proactive track of your editors, contributing authors and enlightened consultants.

Example:

In a recent budget meeting, one young hospital CFO cautioned physician-executives and healthcare administrators to watch every dollar in anticipation of a softening economy. Yet, his more seasoned CEO responded:

Fiscal prudence is important, but if you are asking me to take my foot off the gas pedal, my position is that we should choose not to participate in this recession.”

He further opined that we all must anticipate changing cycles, recessions and adverse demographics. But, let’s not make it a self-fulfilling prophecy. It is the astute CEO who realizes that strong financial statements lie in effective negotiation skills and the management of revenue cycles.

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And conversely, that strong entity management and informed decision-making is the basis of an enhanced revenue cycle. In practical terms, this means understanding the process and targeting core aspects revenue growth to fine-tune and support the entire healthcare enterprise.

And so, if you are not a subscriber to this blog, or to our print journal, we trust you will review, communicate, use and profit from both. Let Healthcare Organizations [Financial Management Strategies] enhance your knowledge of modern [new-wave] health-economics, finance and collaborative medical management and avoid its confusion with the traditional [non-Healthcare 2.0] dismal-science.

PS: Don’t forget to review-read-rave and rant online at this communications forum.

Conclusion:

Your thoughts and comments are appreciated; especially from our print journal guide subscribers and all readers of this professional network.

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Speaker:If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

Subscribe Now:Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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