The healthcare provider seat is getting hotter and hotter as technology companies stateside and close offshore competitive models encroach on the status quo. Healthcare providers do business as usual at their own peril.
A recent survey by the Center for Connected Medicine of healthcare IT executives, for instance, showed that 7 in 10 are “somewhat concerned” about technology companies like Google, Amazon and Apple entering the healthcare space. Just 17% said they were not concerned while 10% said they were very concerned, reflecting JPMorgan CEO Jamie Dimon’s observation that the bank’s healthcare venture with Amazon and Berkshire Hathaway “pissed off” some healthcare executives.
These concerns revolve mostly around the ability of those companies to offer a better consumer experience. Other healthcare executives admitted that technology companies would force price transparency, which they claim would lead to “consumer confusion.”
Wow. A better consumer experience and price transparency - sounds just like what we have a right to expect from our healthcare system. Any politicians, academics or healthcare providers claiming consumers are inept is old and tired, as Regina Herzlinger, the mother of consumer-driven healthcare, deftly pointed out in her book Who Killed Health Care? America’s $2 Trillion Medical Problem – and the Consumer-Driven Cure, and I expounded upon in my book Bill Please: Consumers Driving Health Care.
This flimsy, frankly offensive excuse for getting in the way and not allowing consumers and free market principles to fix our healthcare system just won’t fly anymore. I fully expect these technology companies’ entry into healthcare to further prove this point.
And just off America’s shore in the Cayman Islands is another reminder that the healthcare status quo is headed the way of Yellow Cab, Kodak, & Borders in the face of Uber, digital photography, and Amazon.
In 2014 Narayana Health, in a joint venture with America’s largest not-for-profit health network Ascension, opened Health City Caymen Islands (HCCI) beating U.S. healthcare prices by 60 to 75%, with glowing patient reports to boot, and projections of significant profits once patient volume picks up. Three years in, HCCI has seen about 30,000 outpatients and over 3,500 inpatients, performing almost 2,000 procedures with a zero mortality rate. HCCI is accredited by Joint Commission International, which further endorses their quality outcomes.
The HCCI model, with zero copays or deductibles, free travel for the patient and a chaperone for 1-2 weeks, is potentially very disruptive to U.S. healthcare – and would actually save insurers a bundle. A team of U.S. doctors that visited HCCI came away stating, “The Caymen Health City might be one of the disruptors that finally pushes the overly expensive U.S. system to innovate.”
As the Healthcare Providers’ seat heats up – hopefully these new entrants will motivate them to become part of the solution – or get out of the way.
Sources: Govindarajan, V. & Ramamurti, R. June 22, 2018. “Is this the Hospital That Will Finally Push the Expensive U.S. Health Care System to Innovate?" Harvard Business Review Retrieved 11/27/18 from: https://hbr.org/2018/06/is-this-the-hospital-that-will-finally-push-the-expensive-u-s-health-care-system-to-innovate
Sweeney, E. 11/21/18 “Survey: Most health informatics executives see ‘big tech’ as a threat," FierceHealthcare Retrieved 11/27/18 from: https://www.fiercehealthcare.com/tech/survey-most-health-informatics-executives-see-big-tech-as-a-threat
Well, the GOP managed to slip a repeal of the ACA's individual mandate into their new tax law. But will it topple the ACA apple cart?
I doubt it.
Because the individual mandate, designed to "require" young, healthy Americans to buy health insurance never worked. The young, healthy millennials I spoke to just did the math - 5% of their income or a minimum of $695, whichever is lower - and compared that to hundreds of dollars a month to buy insurance they may not use? They just paid the penalty. Or they didn't.
Fact is, the IRS had no real way to enforce the individual mandate. The IRS can’t bill people that didn’t buy health insurance. It can’t garnish their wages, threaten tax evasion charges or report them to the credit bureaus. All it can do is deduct the fine from their tax return. If they have the right amount withdrawn, they won't get a tax refund to deduct the penalty from.
The fear that only those who need health insurance will buy health insurance was already happening.
But let's talk about the real problem here.
An opaque, inefficient health care system with skyrocketing, unsustainable costs.
Health insurance, while not lily-white in their dealings, has nothing to do with this real problem and fretting over young, healthy people buying health insurance will not fix the real problem.
We need a transparent, accountable, affordable health care system.
As I've said before, if health insurance and the government, who are both practicing medicine without a license, stepped aside, and it was just consumers and providers, health care would get fixed in a jiffy!
Gee. How about health insurance companies and the government pitching in with a clear focus on empowering consumers, then staying out of the way!
We've still got a long way to go. I know you're weary - and so am I. But we've got to keep stating that we want consumer-driven health care - now.
Yeah, I just wrote the last post - and bam, Congress got something done - for now. A two year bipartisan deal to pay the cost sharing reduction subsidies. Don't know if it will pass through the full Congress. Trump supports it - for now. He still has his sights set on a full repeal and replace, though, tweaking the Graham-Cassidy-Heller-Johnson bill. And the saga continues... .
Meanwhile, emphasize to your public servants in Washington anything they decide to do needs to empower consumers to drive health care... .
Is anyone else having Deja Vu? It seems to me that Trump has just done what the GOP was criticizing Obama for - unilateral (and illegal?) decision making on health care, slinging that pen on those executive orders like there's no tomorrow.
I seem to recall the GOP suing the Obama Administration for cost sharing reduction subsidies without appropriation approval through Congress - and winning (which was in appeal), because that is not how our government is set up. Appropriations of our tax dollars are supposed to go through the legislative process - one of the differences between a democracy and a dictatorship.
Trump's announcement last Friday that he has signed an executive order to not pay those cost sharing reduction subsidies to insurers, stating his administration is heeding the advice of the Justice Department, may stick, even in light of the lawsuits that are racking up. There is the sticky point that the insurers were promised those payments by a former administration, and changing horses in the middle of the stream may still end up in legal quick sand, but there also is a legal standing.
Now Trump's other health care related executive orders - selling insurance across state lines and the right to purchase health care plans through formed associations, with some other items added in - the jury is still out.
What can you do? I sound like a broken record, I know - but we deserve transparent, affordable, accessible, high quality health care in America, and until we are dealing with those issues, we won't get it. Tell your public servants in Washington that we need consumer-driven health care.
I realize I'm in health insurance, but just imagine what would happen if there were no more health insurance and no more employer health care benefits and no government practicing medicine without a license. Wham! It's all gone. What would happen? We would immediately have affordable health care because it would be back to the providers and the patients - us. Providers, pharmaceuticals, and everyone else in the health care industry could no longer hide behind insurers or employers or the government - they would immediately have to figure out how to provide us with their services at prices we could afford.
Now, I realize health insurance serves an important purpose, but you see my point. Maybe I, health insurance, the government, and employee health benefits need to take a year-long vacation. When we come back, rested and refreshed, bet you the health care industry has figured out how to do or die. Bet you consumers then have the transparency and the quality competitive choices they need to shop effectively for the health care that is right for them.
I repeat - tell your public servants in Washington that we need consumer-driven health care - everyone except doctors need to stop practicing medicine without a license - and they need to put their eye on the right ball - health care transparency, affordability, accessibility, and quality.
Oh, and there's no room for loner cowboys. This is a democracy, for the people and by the people. We want our democratic system honored, respected, and intact. We elected all of you - not just one of you. Stop acting like Washington is a sandbox. Grow up and get 'er done - together.
If the GOP wishes to repeal and replace the ACA with just their majority under the rules of the Reconciliation Act - their time is quickly running out. On September 30th that option expires.
GOP Senators Graham (R-SC), Cassidy (R-LA) and Heller (R-NV) are the main sponsors of what looks to be the GOP's last hope, which pushes block grants and health care decision-making to the states. See a major point comparison with their bill and the ACA here.
Don't forget to contact your representatives and let them know, as a consumer, you want control to achieve transparency, accountability and affordability in America's health care once and for all.
Rylan Klaseen & Associates
Serving Southern California: