Complexity

One hot topic amongst extra-terrestrials recently is the plan of change in the hospital funding system.

That sounds logical: for sure one should allocate the resource according not only to the number but also the complexity of the cases.

The problem is: how do we define complexity ? I shall not elaborate on the problem on the use of computer coding for diagnosis and procedure as the yardstick. The real fundamental problem is: The proposed system awards physical activity rather than the effect. Is a patient who had a whole body MRI (or other autopsy-equivalent investigation) and needs to stay in hospital for weeks more complex than another who is sent home by the consultant the next morning after admission ?

No, the two patients may well have the same problem - just that the latter one is cared by a capable and confident physician, who spots the problem right from the beginning and starts effective treatment.

(Oh, it is somewhat like Philo Vance in The Benson Murder Case. The whole of the New York Police Department had no clue on who the murderer was despite working like chickens of no head for several weeks - but the solution was crystal clear within half an hour after the great detective arrived at the scene. An auditor outside the solar system would conclude: You just solved a simple case !)

Well, with the new system, a capable but realistic physician would not need to think - even if he could spot right at the beginning what the problem is, he would go for all expensive and useless things to prove the case is difficult. (In reality he will actually screen for all occult comorbid conditions to make the case difficult.)

As Lao Zi (老子) said: 聖人不死,大盜不止.