An ominous sign from Conseco. The insurer has diverted a portion of its long term care policies to an independent trust - a prelude to what I suspect may be a divestiture from this offering altogether. Conseco may be the first domino to fall in a long line of insurers who see where the state of health care is headed and want no part of it.
While Washington falls all over itself doling out goodies in an effort to spend us out of short term financial meltdown, it appears to be paying scant attention to this 800 lb gorilla of the health care continuum waiting in the wings...
And you think you pay too much for health care now? You ain't seen nothin' yet...
Wednesday, December 3, 2008
Subscribe to:
Post Comments (Atom)
5 comments:
I am a partner in a Strategy and Leadership consulting firm and our focus is almost exclusively in healthcare. (I am also a veteran of 20 years in the Air Force and retired in 2000). The Institute of Medicine published a report in 1999 titled “To Err is Human” and conservatively estimated that we kill between 48,000 and 98,000 people per year due to medical errors. That means every 16-32 days we kill the number of Americans killed in the entire Iraq war and no one seems to be interested in putting the Healthcare delivery system into the discussion of healthcare reform. One more thought on the delivery system from a strategic perspective. The only way to be paid if you provide healthcare services is to “do something” to a patient. Fundamentally, any strategist knows that before you can have a strategy, you must first have a clear objective. The current healthcare system does not support the objective of “keeping people well”, in fact, it only generates revenue for providers when people are sick and something is done for the sick person. That fact alone should make people see the need for fundamental change to the delivery system with an added revenue producing Service Line of Wellness.
The American public needs to hear about the size and scope of the problems in healthcare in a way that is understandable. For example, if your audience purchased an automobile, let’s say a Chevy, where would they take that car for service? Would they go to Ford? No, they’d go to a Chevy dealer because they’d know that they Chevy dealer was trained on Chevy’s, not Fords and all their equipment was for Chevy’s as well. (This example assumes of course that both Ford and Chevy are open for business) What if that same customer needs Brain Surgery? Do they go to someplace who has all the right tools and training or do they simply go where they’re told assuming that the quality of care is the same. We know for a fact it is not the same (see the stats per day that I listed above). Healthcare Delivery is very non-strategic and very unfocused and it must be changed if we have any hope of improving quality and lowering cost which ultimately means improving value. There is wide variance in the quality of care provided across the healthcare system, but who’s providing any meaningful data? The answer today is it’s a scattered approach at best, but change is coming in that key area, dissemination of unbiased quality and cost information. It’s just coming too slowly.
Other issues include length of insurance contracts, overutilization of services, poor health habits, lack of patient compliance, malpractice laws, lack of utilization of Evidenced based protocols, measuring the health of the patient over time and comparing those results based on “value” and reimbursing based on results not activity, electronic storage of patient records and tests and the list goes on and on. All of these issues must be addressed in any meaningful discussion of healthcare reform or we can expect more of what we currently have with Medicare. In 2075, Medicare will consume 90% of all Federal Taxes. Let me say that again, in 2075, if nothing in the system changes, Medicare will consume 90% of all Federal Taxes. How could we possibly add more government insurance coverage without seriously overhauling the delivery system? We need the public to push their representatives to embark on meaningful reform or everything else we’d like to do as a nation will be hostage to healthcare costs.
Mods -
Terrific post. My hope is that you have the ear of some influential policymakers in your line of work.
GG
Thanks GG. We are always looking for ways to grab the ear of someone who really wants reform. So far my experience says the large lobby of the AMA and the Insurance Companies will force this into a slow and incremental process versus a true ten year plan to establish a healthier system both clinically and fiscally. You're original post was accurate, "you ain't seen nothing yet".
Mods -
I work on the commercial data and analytics side of the health care business, and can attest to your experience with the AMA and insurance carriers. I find it interesting where the AMA comes down on the issue of the provision of prescriber information for commercial purposes, yet is one of the largest sellers of data to the industry.
Unfortunately, each of the issues you correctly cite as essential to any substantive health care reform comes with its own set of lobbying and iterest groups with agendas not necessarily in lockstep with the goals of increasing value and quality, while reducing cost.
GG,
The complexity of the problem and the intertwined interest groups make an easy, cheap or simple solution elusive. It's the main reason I think the public needs the IOM numbers put in front of them everyday in order to gain the mass and momentum required to move the solution along against the tide of stakeholders who like the status quo or some version of it. A non-educated electorate will be unable to lead or demand change, so we better keep the dialogue going. Cheers.
Post a Comment