A big local healthcare fight headlined our city’s newspaper this morning; it made an interesting point. Seems a local HMO group with a hospital, a group medical practice and a captive insurer spun off the doctors’ group, then contracted with it for services to the insured patients. They thought the doctors weren’t working hard enough; their services cost the insurer too much. Then, the hospital and insurer were acquired by a national outfit. Meanwhile, the doctors’ group merged with a bigger one. And demanded a flat percentage of the insurer’s premiums per patient served, no more fee-for-service. So the hospital and insurer, who said: Hell, no!” are looking for new doctors and both sides are at very costly war trying to grab the existing patients. Messy!
But the part of this we all need to consider came in one little throw-away sentence late in the story. The writer was explaining the cause of the breakup that lay behind the demanded change in doctors’ compensation. It is this: Healthcare used to be about curing the sick but that’s gone. It is an unaffordable model. Health care is now about keeping the largest number healthy and the industry and government! are reshaping themselves to meet that new set of goals, discarding the older ones. You might want to consider what may come out of that, since you’re the beneficiary. You may also wish to think about why your doctors, insurers and politicians haven’t explained this to you.
Put simply, it means healthcare is now considered a service funded by a limited store of money and therefore, must be delivered in the most cost-effective manner to the largest possible number of people where it can obtain maximized results. In simpler terms, now that healthcare is a government goody, it must please the maximum number of voters rather than save the sickest few. You get few votes from the dead and dying, right?
So at dinner tomorrow night, I’ll raise a glass of (healthy, at least this week) red wine to your health…sooner or later, you’re likely to need it!