RWL Newsletter #54
I've been running around New England again this past week, visiting our student interns at a variety of healthcare organizations - hospitals, nursing homes, physician practices, etc. (That's a shot of the train tracks while I was waiting to catch the Amtrak down to Boston.) I had a chance to visit with a community hospital CEO who I know and when we got to talking about what the interns need to know more about, he said they should be thinking more about consumer driven healthcare. He believes that is a major force going into the future, not just a temporary blip resulting from ACA policies with high deductibles. So this week's theme is around market-based reforms that are happening now in our economy, in reaction to, independent of, or in spite of "health reform."
Read
What: HBR, Why GE, Boeing, Lowe’s, and Walmart Are Directly Buying Health Care for Employees
https://hbr.org/2017/06/why-ge-boeing-lowes-and-walmart-are-directly-buying-health-care-for-employees Why: This is back to the future. Before the advent of wide spread health insurance, direct purchase of care by organizations, both employers, but more commonly clubs ("lodge practice"), was quite common. It's interesting to see that the unsustainable rate of growth of insurance is resulting in a return to pre-insurance ways. For a good book on this subject, see David Beito's From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890-1967.
Watch
What: John Stossel, Free Market Medical Care (10 minutes)
https://youtu.be/K4I44BcK39Y
Why: Stossel takes a little romp through free market forces that are outside of insurance - private and government. This video includes a review of services not covered by insurance (cosmetic surgery, lasic), medical tourism, consumer driven healthcare.
Listen
What: Econtalk, Sally Satel on Organ Donation (60 minutes)
http://www.econtalk.org/archives/2017/07/sally_satel_on.html
Why: We have market failure for kidneys in the US, largely because cash for kidneys is illegal. Should we be able to sell our kidneys, at least one of them, while we are alive? We find the idea reprehensible. It's someone's health, after all. Satel (a physician and kidney recipient) advocates for a mechanism for exchanging cash for kidneys. From the podcast:
"No one says to the surgeon, 'We'll give you a $50,000 tax credit for every one of these you do,' or a $5000--whatever it is. We're not--I don't want you to get paid for it, of course, because that would be immoral and it might make you think that the human body is like, oh, I don't know, a slag mine, some kind of coal mine. So, we're not going to pay you directly, and we're not going to pay you right away, because I want you to do it for the good of the patient. So, obviously, the surgeon is somehow managed to live a decent life and survive being paid directly a full, semi-market--it's not a market amount, of course, because it's all messed up--but they get cash. They get what's called cash. And yet, you are going to make a poor person who wants to transform the life of their child, for example, wait 5 years to get their money."
That's it for this week! Drop me a line and let me know what you think. I really like hearing back from you about the links you liked.
Thanks for reading and see you next week!
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I'd love to hear what you think of these suggestions, and I'd love to get suggestions from you. Feel free to drop me a line by e-mail, or you can tweet to me at @bonicatalent .
Mark
Mark J. Bonica, Ph.D., MBA, MS
Assistant Professor
Department of Health Management and Policy
University of New Hampshire
(603) 862-0598
mark.bonica@unh.edu
Health Leader Forge Podcast: http://healthleaderforge.org
Twitter: @bonicatalent
"I know of no more encouraging fact than the unquestionable ability of man to elevate his life by a conscious endeavor." - Henry David Thoreau