Not Good News

[ZenGum]

I can think of three possible solutions, but I don't think any of them work.

1. Publish each hospital's success rate / complication rate / adverse outcome (death) rate on a comparative website, so people can choose to avoid the worse hospitals.

2. Hospitals don't get paid for operations where complications develop.

3. Hospitals get a flat rate for each type of operation (i.e. $5,000 for an appendectomy) regardless of complications, the average cost of which would then be spread over all operations of that type.

The big problem with all three of these is that they give hospitals a motivation to refuse to do operations on higher risk patients. This would be bad.

So, we could oblige the hospitals to do the operation, regardless of higher risk factors. Again, bad, sometimes a doctor should rightly refuse to do a surgery.

Clearly, the solution is to mumble mumble mumble as soon as practical.