A few years ago some enterprising writer decided to do a story that was so obvious that almost everybody else missed it. Go to a major league baseball game and you’ll see that the baseballs themselves are used and discarded with the frequency usually reserved for tissue paper during flu season. Does a ball have a nick or a scuffmark, or does it just not feel right to the pitcher? Then throw it away. That’s not counting the balls used for batting or fielding practice, or just having a catch. It’s been estimated that the average team uses between 35,000 to 55,000 balls a season, counting spring training and batting practice and everything else. Game balls last only about six pitches. It’s conceivable that Major League Baseball uses 1.7 million baseballs a year — a huge expense.
It pays to look closely at things. Managing Editor Frank Diamond’s cover story looks at the adage that “improving quality saves money.” So much of the processes that medical and pharmacy directors at health plans implement start with this assumption. Meanwhile, the idea’s main proselytizer over the last couple of decades, Donald M. Berwick, MD, is now the administrator of the Centers for Medicare & Medicaid Services. It’s no surprise, then, that much about health reform derives from the proposition that quality saves.
About 30 percent of what’s spent on health care is wasted, the theory goes. That 30 percent would more than pay for the upfront costs of providing quality care. Yet the 30 percent figure has always been a rough estimate, points out one of our Editorial Advisory Board members, Michael L. Millenson.
For certain, there have been sporadic instances in controlled settings in which it’s been documented that, to use the term from industry, “quality is free.” Is it, though? Is it really?