By JIM PURCELL

Donald Trump’s website has a position paper entitled “Healthcare Reform To Make America Great Again.”  And some of his suggested reforms make sense.  However, the question of the moment involves Item 2:

“Modify existing law that inhibits the sale of health insurance across state lines.  As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state.  By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.”

This is not by any means a new proposal.  Despite being supported by most Republican Presidential candidates, it has lingered around for decades without going anywhere.  And for good reason.

The driving argument is that this would permit increased competition amongst insurers which would lower premiums.  While it is true that competition might increase, it is highly doubtful that the result would be lower premiums, and there are considerable consumer protection concerns as well.

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BY JIM PURCELL

We have a healthcare system that is provider-centric indeed.  Why else would we call the consumers of their services “patients?”  Perhaps because they have to be patient.  Patient because they have to wait long after their appointed hour to be seen.  Patient while waiting in the Emergency Room.  Patient because the healthcare system is rigidly resistent to change.  Patient because even the most advanced providers measure quality based on “best practices” rather than outcomes.  Do you care about whether your physician employed best practices if your outcome was bad?  Ummm, nooo.

So let’s rename patients right now.  How about “consumers?”  For sure they are, although in today’s dysfunctional healthcare “system,” they rarely pay the providers whose care they consume.  But let us not hesitate over that anomalie, which may be slowly changing.  Up to now, we as consumers of healthcare rarely even choose our providers.  They are chosen for us by other providers.  And if we want to be good shoppers and choose ourselves?  How do we do that when we cannot determine how much a provider costs or how good he or she is?

Oliver Wyman’s Tom Main and Adrian Slywotzky got it right when they opened their superb article with the following observation:

“For many people, the word “consumer” sounds out of place in a discussion of healthcare.  And indeed some of the woes of our system arise precisely from our (mostly ineffective) effort to keep commerce away from medicine.  We thought we were protecting the autonomy of physicians, but inadvertently we created a system that rewards waste and failure and makes it difficult to deliver optimal care. Continue reading…

By JIM PURCELL

Just what on earth are businesses thinking?  Companies pay too much for poor quality health care coverage. If this were any other business expense, this wouldn’t be tolerated. Yet, expensive, sub-standard healthcare is something U.S. companies roll over and accept.  There are many reasons why, all unacceptable.

Fortunately, there’s a path that companies can take now to address healthcare costs: fostering healthier employee lifestyles.  This is perhaps the only avenue for immediate action that can lower healthcare costs for both employers and employees while cultivating a healthier, more productive workforce.  Your cynical side laughs?  Consider this:

“Only private business, not the federal government, can solve America’s epidemic of obesity, chronic disease, and runaway healthcare costs by investing in the health and fitness of their employees,” said Cleveland Clinic CEO Toby Cosgrove in an Affordable Care Act debate panel, a sentiment increasingly echoed inside and outside of healthcare.

Employers must move away from the adversarial, zero sum approach of increasing employees’ share of the cost of coverage to a more partnership-centered model of forging employer/workforce partnerships where both companies and employees support each other’s goals, not just in lowering coverage costs, but by improving health.  

Increasing coverage in this day and age? Unheard of! But this is not a pipe dream. If companies are willing to make the investment, on the condition that employees undertake required behavior modifications and achieve positive outcomes, it truly can happen. And though may have heard this before, up to now we’ve not done it right.Continue reading…