Lawton R. Burns and Mark V. Pauly
Originally posted December 9, 2018
Here is an excerpt:
Why does this kind of behavior occur? While flat-out dishonesty for short-term financial gains is an obvious answer, a more common explanation is the need to say something positive when there is nothing positive to say.
This problem is acute in health care. Suppose you are faced with the assignment of solving the ageless dilemma of reducing costs while simultaneously raising quality of care. You could respond with a message of failure or a discussion of inevitable tradeoffs.
But you could also pick an idea with some internal plausibility and political appeal, fashion some careful but conditional language and announce the launch of your program. Of course, you will add that it will take a number of years before success appears, but you and your experts will argue for the idea in concept, with the details to be worked out later.
At minimum, unqualified acceptance of such proposed ideas, even (and especially) by apparently qualified people, will waste resources and will lead to enormous frustration for your audience of politicians and outraged critics of the current system. The incentives to generate falsehoods are not likely to diminish — if anything, rising spending and stagnant health outcomes strengthen them — so it is all the more important to have an accurate and fast way to detect and deter lies in health care.
The info is here.