We live in a culture of bling in which heat and chutzpah trump almost everything—what else explains the fact that Kim Kardashian expects to rack up $200 million for a game app in the Apple store? Given that, and the fact that India just put a satellite into orbit around Mars for a fraction ($74 million) of what we spent ($671 million) to send MAVEN to Mars, I’d like to take a few of your minutes to praise the virtues of thrift, despite the fact (or maybe because of it) that we are a country with a nearly $18 trillion dollar debt and an unsustainable Medicare program.
How did India achieve so much with so little money? According to an article in the Wall Street Journal, the country relied on basic, older technologies and leveraged an orbit around the Earth for momentum in order to slingshot its relatively small rocket towards the Red Planet.
Doesn’t that sound like old-fashioned Yankee ingenuity? We used to be a country that understood thrift. Remember Benjamin Franklin and his Almanac wisdom about pennies saved being pennies earned? We need not look even so far back. I caught a handful of hours of Ken Burn’s terrific new documentary on the Roosevelts. FDR is much maligned by conservatives and Libertarian types for his New Deal, but when WWII started, Roosevelt understood he could shut the Works Progress Administration down and replace it with the War engine (albeit under protest from Eleanor)—plainly, we couldn’t afford both.
CMS issued a report earlier this month trumpeting the progress that accountable-care organizations are making in meeting quality measures, but last week we saw two organizations exit the Pioneer ACO program. That’s the one in which participants have downside as well as upside risk. Accountable-care organizations are clearly not the silver bullet that will bend the cost curve any time soon.
A report from the Institute of Medicine, however, provides eye-opening insight into an enormous opportunity for cost savings: Give people the care that they want at end of life, not the care providers think they need.
For old time’s sake, the next time you are tempted to throw dollars at a problem, first try thrift.
Vice President, Executive Editor, Radiology Business
Cheryl began her career in journalism when Wite-Out was a relatively new technology. During the past 16 years, she has covered radiology and followed developments in healthcare policy. She holds a BA in History from the University of Delaware and likes nothing better than a good story, well told.