Worries about procurement of healthcare7 November 2016
The price-quality ratio in healthcare could be significantly better, argues part-time Professor of Purchasing and Supply Management Arjan van Weele. Indeed, healthcare insurers have precious little insight into the quality of the care delivered and also display scant interest in patient satisfaction. Moreover, market forces in healthcare are anything but perfect. “Price increases are simply charged on to the insured, who is totally powerless in practice.”
The increase in healthcare spending in the Netherlands seems to have leveled off in recent years, says Statistics Netherlands. While this may sound like good news, a few simple modifications could make healthcare considerably more affordable for us than the one hundred billion euros per year that we are heading for. Such is the argument put forth by Professor Arjan van Weele, who has for over twenty-five years been responsible two days a week for education and research in the area of procurement and contract management at TU/e, occupying a chair initiated by procurement branch association NEVI.
The operation of market forces is quite inadequate, says Van Weele. It starts with the freedom of choice of the insured, he explains. “You can switch to another insurer every year, but that calls for an intensive search process, which makes such a switch technically complicated. Especially for the minimum income households, for which ten euros per month makes a tangible difference, it is just too complex.”
Besides, in theory consumers are entitled to select their care providers themselves, but in practice that is also a matter of form. “For emergency care in particular, that freedom of choice is simply very limited. In such a situation you are happy with anyone who comes to the rescue.” Moreover, Van Weele concludes that healthcare insurers just do not know how satisfied their clients are with the care providers that they have contracted.
“In negotiations between insurers and
care providers quality is of no consequence”
In the negotiations about rates between insurers and healthcare providers quality is of no consequence, says Van Weele. “It’s only about the rates of the so-called diagnosis treatment combinations. Hospitals get a fixed reimbursement for every broken pulse or appendectomy.” According to him, healthcare insurers do not monitor success rates of treatments. “In a way that even makes it advantageous for hospitals if patients need to come back due to an intestinal infection after an appendectomy, for that entails another treatment that they earn money with.”
Things must and can be better, the professor thinks. After all, given today’s status of IT, proper evaluations are no problem at all anymore. An example in kind that he mentions is Buurtzorg Nederland (where he was a supervisory director). “There they work in teams of a maximum of twelve people, without a management layer. Via a fantastic IT system it is measured how satisfied doctors and patients are with home care, and also how the employees feel about this. Those scores are very high and what’s more, they are cheaper than the competition. I hope that this initiative will be followed on a large scale, for only by making quality and patient satisfaction a priority can we really improve healthcare.”
The quality of education seems to have slipped at TU/e. In the latest Dutch-language guide to universities (Keuzegids Universiteiten), Eindhoven's university has dropped from third place in the overall ranking to seventh place in the course of a year. "It's understandable but it's not good," says President of the Executive Board Jan Mengelers, "and it is all the more reason to push on with introducing an upper limit on student intake to our programs. This is a result of the strong growth in student numbers."
Eindhoven's iGEM team has arrived in Boston. In the coming days, the students will participate in the Giant Jamboree, competing with nearly three hundred teams from all over the world. Their competition entry is their project GUPPI, in which they propose encapsulating tumors in a gel to prevent them growing and spreading.
As well as professors, from now on associate professors (UHD-1) at TU/e may also confer doctoral degrees on PhD candidates. Sixty associate professors were awarded the right to confer doctoral degrees at the start of this academic year after the move was approved by the Upper House of Parliament in the Netherlands shortly before the summer recess. “We couldn't wait to introduce this here.”
Before you google yet another one of my invented diseases and subsequently begin to question the title of this story, let me tell you this. With a new academic year having begun and a shiny new batch of freshmen accompanying it, the university is full of people suffering from the so-called octopus syndrome.