An Entrepreneurial Take On Health Care

[HM2VikingRN, RN]

The facts are inescapable: America spends twice as much on health care per capita as any other country, we have a life expectancy which is 29th worldwide, just below Bosnia-Herzegovina, and we have 46 million without health insurance--and growing. Half of the $2.2 trillion spent on health care is private insurance (employer based) and half is public (Medicare and Medicaid). As our population ages and health care technology gets more expensive, costs are going up faster than inflation and economic growth, which is putting the American economy at a disadvantage compared to our trading partners. Clay Christiansen writes in The Innovator's Dilemma that large bureaucracies are immune to change since they have too many incentives to maintain the status quo , so change comes from the outside. Allowing a modernized Medicare system to compete with private insurance in providing health care for all may just sharpen the competitive juices for public and private providers alike and move our health care system into the 21st century.

A 21st century Medicare system will allow any individual or business to buy in, and it will invest up front in wellness, with a greater emphasis on disease prevention via earlier testing, diagnostics and screenings. High-deductible plans discourage use of these "elective" procedures; low cost walk-in clinics make prevention and early detection more, not less, likely. People without insurance wait until they are sick, requiring the most expensive and least successful treatment. Preventing preventable chronic disease--say diabetes or cardiovascular--from happening or getting worse provides better quality at lower cost. This is the makings of a core package which is required of all Americans.

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Over time, many believe that the private systems will be more efficient and will win in the competitive marketplace; others believe that the heavy administrative costs of the private systems mean that America will end up with Medicare for all. Government's job is to level the playing field, set the rules: let the best plans win. Our 2007 health care system is a lot like General Motors--poorly managed with serious quality issues and burdened by legacy costs, all of which are slowly bankrupting the company. An executive recruiter looking for the next CEO of GM is not looking for a moderate who will manage by increment; he is looking for a bold visionary who will fundamentally change the company and allow it to compete in the 21st century. Our health care system requires just such leadership.

http://www.tompaine.com/articles/2007/06/18/an_entrepreneurial_take_on_health_care.php