Words of wisdom, given the current state of medicine: “If you can’t afford it, don’t get sick.” From Charles Hugh Smith at oftwominds.com:
If each of these is not a part of any ‘reform,’ than all that is being done is pouring money into a monopolizing cartel, just in a slightly different way.
Unbeknownst to those of us with little inside knowledge of the complex financial plumbing of the US healthcare system, healthcare is in a death spiral that will surprise everyone but insiders who grasp the system’s unsustainability.
To help us outsiders understand the death spiral, I asked a senior MD to guide us through “follow the money.”
Trump Blasts “Big, Fat, Rich Insurance Companies” As Lawmakers Propose Ways To ‘Fix’ Obamacare.
Since this is the issue of the day and it falls within my expertise, here are some thoughts.
Executive Summary
Multiple conditions are aligning for a broad re-alignment of medical care delivery in the US, resulting in the development of a two-tiered delivery model: high-quality, efficient, innovating cash-pay for those who can pay and low-quality, wait-rationed care delivery for those who can’t.
If you can’t afford it, don’t get sick.
Health systems make their money through inflated commercial real estate (CRE), sale of patient health information (PHI), consolidation of supply chains, and kickbacks in exchange for redirecting federal dollars. Absent a tiny sliver of procedures, the delivery of healthcare itself is a loss leader. It is a requirement for entry, not a source of value. As such, care delivery managed to prevent loss, not promote innovation.
Most health system CEOs are financial engineers, not care delivery specialists, and compare the size of their real estate management infrastructure with their care delivery management infrastructure; the former is always much more robust than the latter.
Insurers have become utilities, administering government payment programs. Their ability to bear risk as a business model was discarded with the ACA; they no longer have the infrastructure or talent to do so. You might as well ask them to make shoes.
This monoculture, the corruption of monopoly and finally the response to the pandemic has crippled both.
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I thought the immaculate Chicago Jesus Messiah (THE ONE!) fixed all that?
We passed it to find out what was in it.
Be like all smart n’ stuff.