Magazine article Nutrition Health Review

Cull the Overuse, Not the People

Magazine article Nutrition Health Review

Cull the Overuse, Not the People

Article excerpt


In his essay "The Tragedy of the Commons," Garrett Hardin, a biologist from the University of California at Santa Barbara, wrote:

"Picture a pasture open to all. It is to be expected that each herdsman will try to keep as many cattle as possible on the commons.... This is the conclusion reached by each rational herdsman sharing a commons. Therein is the tragedy. Each man is locked into a system that compels him to increase his herd without limit in a world that is limited. Ruin is the destination toward which all men rush, each pursuing his own best interest."

Many humans graze in the health-care pasture. Hospital CEOs have the incentive to maximize revenue, as do the owners of diagnostic testing facilities, kidney dialysis centers, specialty hospitals, and ambulatory surgical centers. Doctors who are paid on a piecework basis are motivated to maximize revenue by treating more people and giving more treatment to every patient who walks in the door.

Health care consultants maximize their revenue when they help hospitals increase the volume of high-cost cardiac, oncology, and orthopedic procedures.

Every pharmaceutical company and medical-device manufacturer has the incentive to maximize sales volume. …

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