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Free Marketeer's Healthcare Scheme Would be Chaos

Cheryl Clark, for HealthLeaders Media, February 28, 2013

For anyone, especially frail, cognitively impaired seniors who might be perplexed by sales pitches from doctors and hospitals trying to influence their choice of care, and for the confused hoi polloi who aren't even sure what sorts of services they really need, Goldhill explains, "organizations will develop," under a variety of payment models.

"They might say, 'We'll take care of all your care for an annual membership fee,' and there'll be discount clubs and pre-pay clubs.  There will be the type of variety of care and payment that we've come to expect in  everything else in our lives."

I told him I consider that scenario impossibly confusing, not just for older people with complex health issues and limited thinking skills, but for me as well.

I also think it would be ripe for charlatans who'd take advantage of the gullible and frail. Human nature being what it is, we'd need another entire layer of watchdog bureaucracy to make sure the people who sold these services were qualified to do so. And another layer of enforcement power to stop them from hurting people, hopefully before they've already done harm.

Goldhill argues that "third-party service" report cards would spring up, such as the safety scores produced by the Leapfrog Group, whose board he has joined, to "actually distill information in a form that's of use to consumers" to guide their choice of hospitals and doctors.

But Goldhill forgets that much of this information used by the Leapfrog Group, and most of it used by many other third party companies like U.S. News & World Report or Truven Health Analytics, comes from Medicare claims data, and other hospital reports, and much of it is posted on Hospital Compare.

I noted that the Patient Protection and Affordable Care Act requires that hospitals be penalized for poor outcomes, such as mortality and readmissions, and hospital-acquired conditions like falls, and hospital-acquired infections.

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5 comments on "Free Marketeer's Healthcare Scheme Would be Chaos"


Wayne Wasden (3/17/2013 at 4:06 AM)
Ms. Clark, You should be ashamed of yourself. Your liberal sermonizing has been placed in stark comparison to individual empowerment, accountability and responsibility. Mr. Goldhill has simply stated facts and the truth about how markets and human nature work. Last I looked market forces continue to work extremely well in the U.S. system, especially when they are not tinkered with or controlled by people who view themselves as wiser than the consumer. It is also a sad fact that this discussion for a significant change to a tried and successful way of doing business will never be elevated because of those who currently exercise control over market forces. And a single payer systems does not significantly alter the incentives so clearly dominating behavior. There is no more broken system than the U.S. Healthcare System with it's incentives clearly exposed and articulated by Mr. Goldhill. Ms. Clark, with all you clout and contacts, do all you can to move this discourse to a higher level. Bravo Mr. Goldhill

MayoVictim (3/6/2013 at 5:03 PM)
There's a simple solution to the US healthcare system. It is just to adopt a European style single payer system. The Europeans have better healthcare outcomes. It costs much less than the US system and when I lived and worked in the UK and Europe I never heard anyone in the medical industry complain about their remuneration. Of course the AMA and their handmaiden in congress have a done good job demonizing what they label as "socialized Medicine" but I can tell you that from my personal experience as a patient and worker in the healthcare industry it's way better than what we have in the US. I'll now wait for nonsense comments about waiting lists and death panels.

MBRose (3/1/2013 at 1:46 PM)
Bravo Mr. Goldhill! Perhaps by thinking far outside the box of 'standardized care' schemes and shaking up the illness healthcare system currently worshiped in this country, true life changing improvements might happen. Maybe the 'Tippong Point' has finally been reached and society will move forward in handing the power for self-care back to the individual and out of the hands of insurance companies and physicians, who have NOT improved outcomes or increased longevity and quality of life in decades...but have become some of the wealthiest and most powerful individuals and corporations in the process. Change, big change, never happens easily or smoothly. Yes there might be some missteps along the way. However it is time to do something differently...anything differently. We have followed this insanity for far too long, doing the same kinds of things over and over again, expecting improved outcomes and results. Isn't that the definition of insanity? Yet we have bought the bill of goods, hook, line, and sinker each and every time! I say bring on a bit of chaos and let real change begin to happen.