3 thoughts on “Metrics”

  1. Puckett’s Iron Law of Bureaucracy:

    “Any system sufficiently constrained by excessive metrics will eventually be overwhelmed by perverse incentives.”

  2. Some things should always set off alarms. Like every time services are disconnected from payments. Part of it is the way billing and insurance are handled. When handled properly there is no disconnect.

    I was surprised how Russian hospitals work. If a patient wants to eat, they pay for it that day. If you want to see your doctor, there is no appointment, the doctor comes and you pay him or her. I never discussed how the hospital stay itself was paid for, but imagine it to be similar.

    Insurance is a very simple contract. Only we’ve screwed it up by calling things insurance that are not. Insurance payments should go to the insured so they pay the service provider directly.

    Billing is just deferred payment. It’s very similar to writing a check. I lived in a small town once where you could buy things by filling out a counter check (no checking account required, it was an honor system.) Going through those motions might help people see the reality better?

  3. I enjoy reading Megan McArdle’s articles, always well thought through.
    NBF put up a post a couple of days ago comparing the health systems of various countries, there’s a lot of diversity but when it came to whose is best, there is no clear leader too many metrics with too many ways to rank their importance.

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