Taking Back The Business of Healthcare with Preston Alexander | E. 67

US healthcare costs are the highest in the world, yet health outcomes lag behind other countries.  Preston Alexander shares his mission to prioritize patient care and clinicians over profit with Jim Cagliostro. 

 

Episode Introduction 

Preston explains that the principal issue with US healthcare is its profit-driven approach, why healthcare must be a forward-thinking Netflix, rather than an obsolete Blockbuster, and why the nursing shortage is the result of a broken system. He also emphasizes how understanding the line item hospital costs can significantly benefit clinicians, and the importance of an empathetic mindset. 

 

 

Show Topics

 

• The current path of healthcare is unsustainable 

• Turn the ship around or build a new one? 

• Clinicians need to understand the business of healthcare

• The ability to analyze financial statements is an invaluable skill

• Hospitals benefit from having clinicians in leadership roles

• Preparing clinicians for leadership  

 

 

06:08 The current path of healthcare is unsustainable

Preston said the profit driven nature of healthcare is leading to higher costs and poorer outcomes. 

‘’. .. I think the primary issue that I see is that, and you talk about systems level problems, is our healthcare system operates within a much broader context. The context being a system of capitalism. And it was created in a way, in more modern times, I suppose, if you want to look at it that way, to maximize profits. And all the systems we've designed have created a little bit of a bifurcated system whereby you have wealthy individuals who are covered by insurance and can afford all the out-of-pocket fees and charges they have to pay if they need healthcare. And then the rest of the population who's functionally uninsured or underinsured or doesn't have insurance at all, and then what they can access. So, if you wanted to just really take one big giant swath, like what's the problem in healthcare, is that it's fundamentally profit driven first, and healthcare fundamentally is a function that can't be delivered appropriately to everyone with profit being its primary driver and outcome. We see examples of it all over the place. You have insurers who are supposed to help you avoid catastrophic costs related to healthcare, who make... United Health Group, I think in 2022 profited $20 billion or something like that. So you're just talking about outrageous numbers. It made, I was just looking at their financials this morning actually, $340 billion in revenue. And it's like, what are we getting for it? More expensive treatments, more cost, worse outcomes, lower life expectancy, less access, more people left behind by financial design.’’

 

09:51 Turn the ship around, or build a new one? 

Preston said the broken healthcare system is the cause of the nursing shortage, but change is possible. 

‘’… I am still going to believe, and I'm probably wrong, but that we can turn the ship because systems are what drives everything.... It's what we see with all the nursing shortages right now. We don't really have a shortage of talent, but we have a brokenness of systems. Today, we're 300,000 nurses short. If I gave you 300,000 nurses tomorrow, we'd be short again within a year or two because the systems are brok