By Barbara L. Heller

Considering the fact that 1973, Storey's nation knowledge announcements have provided sensible, hands-on directions designed to assist readers grasp dozens of state residing talents fast and simply. There are actually greater than a hundred and seventy titles during this sequence, and their impressive reputation displays the typical hope of state and town dwellers alike to domesticate own independence in way of life.

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That was the good news. c01 6/19/07 6:01 PM Page 27 A Few Hard but Useful Truths 27 ..................................... The reward for doing good was not to do well—it was to be financially penalized. The same drop in overall care system revenue happens when the care delivery infrastructure cuts the rate of heart attacks or asthma crises. Revenue drops. No one is rewarded. Caregivers are financially penalized. Incentives to create efficiency do not now exist. Disincentives abound. Guess what happens?

Anyone who wants to apply market forces more constructively to health care needs to understand that basic truth about how market forces actively work. Customers are the key. Products without customers do not survive. Products with customers thrive. Business units that produce what the customers actually buy have both revenue and economic sustenance. Business units with no revenue are gone quickly. Business units all respond to the customer. You basically get what you pay for, and you survive as an economic unit only if you get paid.

C01 6/19/07 6:01 PM Page 29 A Few Hard but Useful Truths 29 ..................................... thinking applied to the care of our patients with depression, charting out the right interventions, the right treatments, the right prescriptions, the right tracking, and the right follow-up. Non–systems thinking will just get us to where we are now—the most expensive care delivery economy in the world, with marginal and unmeasured outcomes and over 45 million uninsured people. I’m not suggesting that we want, need, or should create a marketplace where physicians should be forced into “rules-based” medicine.

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