Why Choice is Important in Healthcare

THESE ARE INTERESTING TIMES IN HEALTHCARE AND LABORATORY TESTING—both here and across the globe. In the United States, elected officials in Congress are busy assembling 1,000-page bills to make over the nation’s entire healthcare system under the guise of extending coverage to those who are currently uninsured.

Overseas, the healthcare systems of other developed countries are showing cracks caused by a demand for health services that exceeds existing capacity, along with a rate of growth in health spending that is not only unsustainable, but is causing fiscal and political crises in some nations.

The American public remains oblivious to these many important stories about healthcare crises, innovations, and issues—and the analysis needed to understand them—because today’s media outlets have migrated to milking the spectacular pop culture story of the moment, whether it is the death of Michael Jackson or the revelations concerning David Letterman’s blackmail threats and his philandering with interns and other younger females on his staff.

For our part, THE DARK REPORT is working to fill that information vacuum by offering our clients and regular readers coverage of events outside the United States that directly touch pathology and laboratory medicine in both negative and positive ways. It is my view that pathologists and laboratory managers in this country can benefit from knowledge about how other health systems are handling laboratory testing in their own country.

Two notable examples are featured in this issue of THE DARK REPORT. On pages 3-5, you will read about the latest developments in Auckland, New Zealand, involving the troubled start-up of Labtests, the new monopoly lab granted an eight-year contract by the region’s District Health Boards. Patients and physicians are unhappy with Labtests’ service deficiencies. But because it is the only lab provider in the metropolitan area, they have no other option.

Similarly, on page 16, we provide an update to the Irish Pap smear outsourcing program. In recent weeks, flaws in the design of the government plan for cervical cancer screening have surfaced. Many physicians are publicly criticizing these deficiencies. But since it is the only major source for cervical cancer screening in Ireland, they and their patients lack the ability to choose another solution.

My message from these two stories is that “choice” is an important element in our American health system. As both patients and providers, each of us benefits from how choice fosters competition, which encourages good service!


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