I have to admit, the only reason I read this article in the first place was because of who authored it: Billy Beane, gay former baseball player [fixed], Newt Gingrich, former ultra-conservative congressman, and John Kerry, senator and former presidential candidate. It’s basically a good article that says that if we followed baseball’s model, we could have a first-rate healthcare system.
Update: Apparently I was wrong and there’s another Billy Bean(e) out there. Sorry, how was I to know? As a gay person, I have tunnel vision when it comes to the Billy Bean(e)’s of the world. I should have known Newt Gingrich couldn’t work with a ghey. After all, he can’t even bring himself to agree with his ghey half-sister.
P.S.: I know what you’re thinking, “Michael D. wrong about something? NO!!”
P.P.S.: Still a good article though!
notmark
Not the gay Billy Beane; the article writer is the subject of Moneyball and is the GM of the Oakland A’s.
Mazacote Yorquest
Uh, Michael, Billy Beane is the general manager of the Oakland A’s. Billy Bean is the formerly gay MLB player. I mean, Beane may be in the closet, but Bean certainly is not.
Barbar
Billy Beane is the not-gay former baseball player and current GM of the Oakland A’s; Billy Bean is a former gay baseball player.
Michael D.
Well. they need to make that clearer, goddammit!
Mazacote Yorquest
Just remember, the "e" stands for "’eterosexual."
passingby
Wait, so he’s formerly gay? What changed his mind?
MikeL
"Billy Beane, former gay baseball player"
I think you meant to say "Billy Bean, gay former baseball player"
Billy Beane is a different baseball player, not to be confused with Billy Bean.
Lemme tell ya, ball players have all kinds of names these days. Hu’s on first, Watt’s on second…
Jay Severin Has A Small Pen1s
Holy crap! The Oakland A’s general manager is gay? WTF!
MikeL
I swear, there were no comments when I started….
Comrade Desert Hussein Rat
@Mazacote Yorquest:
What he said.
Billy Bean came out as gay after his career as a player was done.
Billy Beane is know primarily as the Oakland A’s GM who built them up into a power on a shoestring budget by applying Sabermetrics to the art of managing a major league roster, and is the author of Moneyball.
No offense against Billy Bean, but Billy Beane probably carries a bit more weight when talking about health care.
I agree with your main point, in any case. When you see guys as disparate as Gingrich and Kerry talking about Health Care and jointly authoring a decent editorial on it, it heartens me that something good may finally get done on that front, after a Democrat gets elected to the White House, anyway.
Quicksand
How do you play gay baseball? Dare I ask?
Cris v.3.1
I read it as Billy Keane, the firstborn of the Family Circus clan.
Shibby
As a medical student I think this is a pretty good idea.
Evidence based medicine is not really a new concept and we have many resources at our disposal to look things up quickly (UptoDate and Access Medicine come to mind in addition to other mobile resources).
However, due to the huge volume of information that we are expected to know and apply, any efforts to improve our efficiency would certainly be greatly appreciated.
Right now specialists pretty much are required to own a subscription to many of the journals that deal with their field. Weekends and evenings are often spent reviewing these to keep on top of things.
There are many other factors that play a role in influencing evidence based medicine such as the abundance of pharm reps and entrenched habits, but those are rants I’ll save for another day.
In short, it’s good for us and good for you.
Cris v.3.1
See, on first base is Hu, Samuel Hu. You’re probably not used to that name because his grandfather was Chinese. And on second base is Hector Watt, W-A-T-T Watt, and that’s not such an odd name because James Watt invented the steam engine.
jake 4 that 1
@Quicksand: Well you need a pitcher and a catcher…
JL
Gee, I saw Newt’s name and decided not to read the article. Maybe I’ll go back to the NYTImes site and read it.
SamFromUtah
if we followed baseball’s model, we could have a first-rate healthcare system.
Give everybody lots of steroids?
Dr. Squid
Billy Beane is the GM of the Oakland A’s. Billy Bean (no e) is the gay utility infielder who’s a bit younger than Billy Beane.
Quaker in a Basement
Oh. My. God!
Someone has actually gone and said it. While opponents of more rational systems keep shouting "Best. Healthcare. EVAR!," these three have finally written what no one wants to admit–we pay waaaay too much for what we get.
Separate note: Billy Beane and Bill Bean once played on the same minor league roster and batted in consecutive spots in the order. I was there at Mile High in Denver when they played against the old Denver Zephyrs.
After they both batted in the first inning of the game, the stadium announcer introduced the next batter this way: "Batting third…Bill Bean…just kidding!"
Dougj
Not the gay Billy Beane; the article writer is the subject of Moneyball and is the GM of the Oakland A’s.
Oakland is right across the bay from San Francisco. Draw your own conclusions.
Zifnab
Part of me just assumed everyone was already doing this. Which is kinda sad because I work in the health care industry. You’d think I would have a better grasp on what people aren’t doing.
All the same, I am entirely for getting more data analysis of medical practices. Because $$$
HyperIon
so…do you intend to update the post so that it reflects reality?
that you would make this mistake is SO unsurprising.
Krista
Michael, you better update the post or this entire thread will be full of comments correcting you.
KCinDC
Hilzoy reminded us today that Gingrich is scum who should be shunned by all decent people, and you want us to read his thoughts on health care?
Unrepentent Dennis - SGMM
They add a tenth player: the Center.
JL
The article is interesting but the comments for the most part are well thought out with a variety of concerns and ideas. Thanks, Michael for pointing it out since I had ignored it earlier.
Shinobi
Y’know I agree with these guys to a point. In an entirely theoretical world I think that using data analysis to drive most health care decisions is good. (Studies have actually shown that the best option is a combination of statistics/computer driven decision making and experts, as they have different blind spots.)
The problem with Data Analysis in healthcare is that at some point we’re going to come down to CTVEVPL, Or, Cost of Treatment Versus Expected Value of a Person’s Life.
I’ve heard a lot of talk about how people have a "right" to healthcare. (A concept I do not entirely agree with,) But in an entirely data driven world someone’s "right" to healthcare would vary based on their value, and their risk. It is one thing to talk about hiring/firing players based on data. But eventually that level of modeling in healthcare is going to come down to letting some people die.
And I"ll be honest, that scares the crap out of me.
Jeff
I heard him speak about this a few months back, and sometimes good ideas come from the foulest sources. Should we discard what most would say is a worthwhile project just because it came from Gingrich? What’s the cut-off on the good idea-bad person ratio?
ScottF
Billy Beane was one of the subjects of Moneyball, but Michael Lewis was the author.
MNPundit
You know my cat is named Shinobi and I hate him. It’s why Beane SABR driven metrics didn’t work perfectly. The Data gets you a long way and puts you in a good position, but in the end it depends on luck and heart to put you over the top because anyone can have a bad day.
So while this is a help, it has to be balanced with compassion.
ScottF
Another amusing footnote — Billy Bean and Billy Beane were teammates on the 1988 Detroit Tigers.
Back on topic, sort of — anyone know of any more endorsements on MTP this weekend? :-)
Jimmm (aka, Jamey)
I think what Michael meant is that Billy Beane is formerly gay. He’s cured now.
Praise Canadian Jesus.
Joe Morgan
Billy Beane authored Moneyball, but it was not a consistent book.
(FJM radar)
liberal
Article’s argument is flawed.
While I’m 100% in favor of evidence-based medicine, and think that not going down that route is indeed costing us lots of money, the problem is that health care providers have no incentive to follow evidence-based medicine.
Why? Because health care providers’ incentive is to make money. You make money by doing procedures. If you follow evidence-based medicine, you’re going to be doing fewer procedures.
Of course, you can argue something like, "we’ll pay providers based on outcomes." Problem is that the real outcome we’re after is "as long and as healthy a life as possible." Meaning, the outcome is a long-term one. There’s no incentive to capture that in e.g. the health insurance market, because if you do things to further this goal, you don’t reap the benefit—the insurer way down the road covering the patient 20 years hence does.
So, unfortunately for free-market worshipping types like Gingrich, the only way to implement a rational health care system is through government.
In other words, we need to nationalize health care itself, not just health care insurance.
For an excellent article whose implicit message is that market incentives in health care simply can’t work, read The Best Care Anywhere.
liberal
@Jeff:
Yes, because Gingrich is a shallow pseudo-intellectual who’s likely never to get into deep ideas.
Jimmm (aka, Jamey)
This isn’t about deep ideas, it’s about common sense. Which, I guess, further disqualifies Rep. Gingrich.
Dammit!
Comrade Nikolita
I still think the US should invest the money necessary (once it’s available) to make healthcare universal in the US. Just easier in the long run and it eliminates the overcharges and incentives from private companies.
But every time I mention that on Fark, someone points their finger at me and calls me a socialist, so I dunno. You figure it out.
All I can say is that as flawed as the Canadian system is, what with shortage of care in some places and ridiculously long wait times and cancellations, it’s still better than the US’ and I wouldn’t trade it for anything. I happily pay higher taxes if it means I can get good medical care when I need it.
Comrade Desert Hussein Rat
@Quaker in a Basement:
Pretty funny.
MobiusKlein
The article must be flawed – the A’s have used the Disabled List more in the past two years than ever in their history in Oakland. (more or less.)
Ok, Ok, I’ll RTFA after all.
Comrade Desert Hussein Rat
@ScottF:
Right you are. Funny thing is, I read Moneyball, and should have remembered that.
Michael D.
@Krista: Updated. But too late for da haters! :-) (I fell asleep early)
slightly_peeved
If the US medical system has the worst value-for-money care in the world, what is the more sensible way to fix it:
(a) Adopt the model used by other countries, that get better value for money (far greater restrictions on insurance companies, universal healthcare), or:
(b) Adopt the model used for buying players in Major League Baseball?
A solution for US healthcare that does not at least refer to the systems in other countries is not a serious solution. If a bunch of other people are doing a task better than you, the first step to improve your ability at the task is to look at what they are doing. I would have thought that was obvious.
ThresherK
It’s late. I’m glad I read to the end of your post. My first inference was a bit shocking.
liberal
@Jimmm (aka, Jamey):
I agree that there’s a lot of common sense, but there are also deep ideas.
For example, here are two which while not rocket science are IMHO relatively deep:
(1) It is likely not possible to create an efficient health care system (and here, I’m referring to providers also, not merely insurers) using market incentives.
(2) Plans to create efficiencies via consumer choice in medicine are bound to fail because consumers will never understand the true cost-benefit tradeoffs, don’t have time to learn such tradeoffs, and are emotionally ill-positioned to act rationally on such tradeoffs.
liberal
@slightly_peeved:
Agreed, and well put.
Which is why Gingrich is disqualified: looking at these other countries and adopting some aspect of their systems will mean a nationalized element to health insurance and possibly even medical care.
Which Gingrich will never concede for ideological reasons.
jcricket
I vote for both. I hate Gingrich with a passion. His personal dishonesty, professional views, etc. make him the person I’d least like to have in charge of any kind of policy initiative.
That said, I am in favor of evidence based medicine, and agree that medicine has become an "old boys club". But as others have pointed out, this is only 1/100th of the problem.
We have to go to single payer (or something like Switzerland has), but moving to single payer doesn’t automatically contain all "out of control" costs or waste. Yes, we can get rid of like 90% of the administrative overhead wasted dealing with our current insurance system. We can automatically lower costs if everyone is in the same big insurance pool. We can negotiate with pharma companies to lower prices. We can make sure independent scientists verify that the new drug really is worth spending more money on than the old generic, etc.
That’s a lot – and would probably cut overall health care spending by 50% in this country.
However, even bigger cost containment would come from two things: 1) Initiatives like what Gingrich is talking about (making medicine itself more effective); 2) Paying doctors on salary instead of per procedure.
I would argue that instead of "evidence based medicine", what Gingrich is really calling for is a huge investment in public health studies. These are the studies of 50 or 100,000 people and their habits over 10-20 years. Besides fundamental/basic science research, public health studies give us the most information about what health care spending works/doesn’t over the long run.
BTW – this may not be popular (esp. in my neck of the woods), but we could save this country $15 billion/year in consumer costs if we simply required practitioners of alternative medicine (or purveyors of herbs and what not) to follow the same standards as "traditional" medicine. Nearly all of it is bunk – wasted money doing nothing for people’s health.
Doctor Jay
I don’t see this as an either-or. Evidence-based medicine, which to my mind goes hand-in-hand with Electronic Medical Records(EMR) is a must-do. And so is some kind of universal health care.
slightly_peeved
Certainly I’d be an advocate of (b), as part of (a); part of my beef with the article is that it somehow treats (b) as an alternative to (a).
Most universal health care systems require the government to make judgements about what operations or healthcare is covered by the government, and have centralized databases on patients. In this case, universal healthcare can far better facilitate evidence-based medicine than the current US system.