Jonathan Bush CEO at athenahealth Follow Healthcare is Broken. Here’s Why. Let’s begin this post with a few simple givens about healthcare: We are all patients. We are all part of a healthcare system that is broken, in too many ways. Good health is good. Choice is good. Profit motive can be good, unless it is trapped in a weak marketplace. As patients, we pay too much for healthcare. And, too often, what we get for that money doesn’t feel good. Some say the cause is the pernicious role of the profit motive in healthcare. I can’t believe I am saying this, but I agree. What’s wrong here? Why do we suffer as healthcare fails to deliver the personalized experience we count on in so many other aspects of our lives? For one thing, it’s because no one knows who we are as patients. We show up at the doctor’s office and have to scribble the same information time and time again. Why? Maybe there are a lot of reasons, but there is one absolute that requires us to sit down with that clipboard and share our personal details yet again: The technology infrastructure in health care is antiquated, light years behind what it should and could be. Let’s say you cut your foot at the beach on the Jersey shore and go to the urgent care clinic a little ways inland. Why does it seem as if you are introducing yourself to the entire healthcare system for the first time? Because you have to. It’s highly unlikely that the doctor at that clinic can pull up your chart and see right away that you are allergic to bees, pregnant, have high blood pressure and are covered by (high deductible) health insurance. But it shouldn’t be. That clinic doesn’t have your essential health care information because the incentive system in healthcare is broken. No one makes money when they share information, and no one loses money when information isn’t readily available. But there is a lot of profit being made in opposition to what patients need and deserve. There are plenty of places to explore this phenomenon, but perhaps the one with the most irony is within the world of non-profit organizations. Health systems, including non-profits, are acquiring doctors to increase their referral pool. In fact, 40% of primary care physician nationwide are employed by health systems, more than double the number employed in 2000. In simple terms, these health systems increase their market footprint by employing more doctors across a region, thus gaining more patients and ensuring that all care options lead back to the same health system – their own. Through consolidation, these systems also achieve bullying leverage against insurers which, in more than a few cases, has enabled them to raise prices on services delivered, even when the quality may not improve. I feel compelled to highlight this much-publicized consolidation issue because it’s symbolic of the fact that health systems—even those that were created through charitable missions—are thriving within a system that is starved for improvement. You can literally see the profit at nearly every non-profit health system out there: The towering marble atriums, elaborate fountains and grand pavilions have become all too common. No incentive for caregivers to share information. Redundant, impersonal experiences for patients. Consolidation that’s tilting the playing field. So is it just me, or is healthcare broken?
Posted on: Mon, 28 Oct 2013 12:13:22 +0000
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