Most of us in Brazil know where this kind of solution is going to end: poorer services, higher costs, neglected quality…. Cut workers income is the best solution to worsen performance… any lean beginner is aware about the impact of cutting costs by cutting wages and personnel, it is formally recommended not to do such things…healthcare reform starts on that.
Back in Brazil quite similar reform took place few decades ago… the impact on healthcare quality is measurable: Brazil doesn’t have 500 (yes, it’s less than five hundred) nationally certified healthcare units/centers (hospitals, labs, clinics, etc.). Brazil has 200 million inhabitants and more than 200,000 healthcare units/centers. Sao Paulo State concentrates 2/3 of these quality certificates, and has more than 50,000 healthcare units/centers. Nobody worried about quality assurance…
Cut costs by cutting service reimbursement are another form of what people now call “brazilification” (I heard it for the first time back in 2000, now it’s getting popular…).
See NEJM publication: http://ht.ly/1IoJa
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