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POLICY/HEALTH PLANS: The future of health plans

I had fun writing this piece on behalf of health plan CRM and Business Outsourcing company Connextions to help launch their new series of Thought Leadership Profiles. Some of the really rude stuff hit the cutting room floor, but given what’s been said about some of their clients over here on THCB I’m pretty heartened that they asked me to contribute.

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richard smithMGMatthew Holtbev M.D.Peter Recent comment authors
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richard smith
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Managed Care; Anatomy of a Mass Medical Movement. 2000. The Rise and Fall of Managed Care: A Comprehensive History of a Mass Medical Movement. 2001. “The author documents that despite promises of managed care zealots, we have a sad healthcare landscape of crippled academic medical centers, dissatisfied patients, uninsured, chronically ill and elderly citizens, and demoralized physicians: with NO cost savings. Managed care produced, however, ‘monetarization’ of medicine, multi-million dollar consulting firms, and Wall Street riches. Dr. Smith wisely reminds us that the best way to care for patients is ‘care for the patient.’ It is not too late to… Read more »

MG
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MG

The best part about the Herzlinger interview in Health Affair is how Bob Galvin (a person with actual considerable knowledge of the topics discussed in the interview including GE’s efforts at P4P and measuring efficiency) consistently refutes or subtly corrects Herzlinger throughout the entire interview. Another thing I don’t understand about Herzlinger is her insistence on constantly comparing the auto industry to the health care industry. It is probably just because she did some much research on the auto industry and can recycle the content – a trait way too common with senior academics. It would have been hilarious if… Read more »

Tom Leith
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Tom Leith

> And didn’t I hedge it … enough for you Tom?
Oh Matthew, of course you did. I’m just surprised you conceded the usefulness of a price signal at all after the recent “conversation”.
The Harvard professor’s got a coherent framework: deregulate health services and financing after the fashion of the communications industry in the 1980s and let the chips fall where they may. This is a framework and its coherent. It simply presumes desiderata we don’t share.
t

Matthew Holt
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Guys…thanks for the comments but regarding “consumerism works” — It’s a “wildcard” which means that it’s a very low probability event. And yes it is possible that I am wrong, which is why scenario planning is a good idea. And didn’t I hedge it with enough “ifs, buts and maybes” for you Tom? Finally I wish that I knew WHAT the Harvard professors point is. I just don’t understand it. But apparently pointing out that she hasn’t created anything like a coherent framework for consumerism in health care in her decade plus of spouting off about the topic just means… Read more »

bev M.D.
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bev M.D.

Matthew;
That was a very lucid interview, and I even got to see your picture for the first time! (: I especially agree with you about the recession scenario, or something similar that sinks the comfortable employer-sponsored insurance currently making many people complacent. Thanks for the link.

Peter
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Peter

“3) Transparency and consumerism works.” The reality: “Many cynics, me included,think that CDHPs aren’t likely to have a great impact on the provider market.” The Fantasy: “But if enough consumers are aggressive about chasing better experience in their health care services, and better outcomes, with their dollars, just maybe there’ll be that tipping point and providers en masse will be forced to react.” Tom, I wonder how far behind universal single-pay care would be if we all had to buy single plan health insurance – with our own dollars? I bet the insurance industry would be the first to compel… Read more »

Buzz
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Buzz

Could it be that certain Harvard professors have the least little bit of a point?

Tom Leith
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Tom Leith

Matthew says something I never thought I would hear him say:
> if enough consumers are aggressive about chasing
> better experience in their health care services,
> and better outcomes, with their dollars, just maybe
> there’ll be that tipping point and providers
> en masse will be forced to react.
It is one thing to let the really rude stuff hit the cutting room floor, but this is quite another thing. Could it be that certain Harvard professors have the least little bit of a point?
t