Centralized Healthcare or Free Market Healthcare.. Are you Serious??

I had to find a new sawbones the other day, as my old doctor decided to hang up the stethoscope. So, I opened the new app everyone has been talking about, clicked on the “think I have the flu” button, and then 28 doctors’ offices showed up. I then sorted by price (high to low) and customer ratings, 4 stars or better.

Each doctor had an easy to understand description of the service, price for the visit, potential costs for related services around the topic of flu visit, availability over next week to see patients, customer ratings and what the price would be if I had one of the insurance carriers/plans. Clicked on my new Quincy MD (she had a friendly face), fair price and a 4.8 star rating. Lickity split, I received a placeholder in my calendar.

Talked to my mom later that day and told her to check out this app. She said ok, as she just moved to Florida and has no idea which doctor to go to. She downloaded the app, entered some authentication data and voila, her medical records showed up on her phone.

She then entered some data points about what she was looking to have done with her shoulder and the magic app presented 18 doctors’ offices and three hospitals that offer shoulder therapy and surgery services. All the prices, detailed description of services, what others have said about receiving those services, prices for each type of service and her expected price for services based on her needs.

She then applied her insurance plan to the service she wanted and got the updated pricing. She picked Dr. Jones because she liked his two-minute video where he talked about how he approaches shoulder issues. Next, she clicked the “Share Records” button which allowed her preferred new doctor at the hospital to have “view-only” access to her record.

She was so excited about how easy the magic app was to use, she went back to the app and started shopping for other healthcare services she had been putting off because of living on a fixed income and not having the information to make a well-informed healthcare decision.

Then I woke up and realized it was only a dream.

But why?

The Problem:

We can buy almost anything in the world today (HT to Bezos, Sears and Walmart) with a full description of the product, what others have searched for with related products/services, prices, customer ratings, etc.. with the click of a button. But for some reason, we have chosen the most important industry consuming more than 10% of most developed country’s GDP and with an annual spend of more than $4.2 trillion a year, to play hide and seek with the consumers.

When was the last time you bought something not related to healthcare, and didn’t know the full cost until a month later?

In the Six Degrees of Kevin Bacon Game, we are all patient zero. Everyone has had to fight over the bill. Why is it that the insurance company, doctor’s office and hospital can tell you what something costs after the treatment, but not before? Hmm.

The main issue facing consumers for healthcare is and has been lack of transparency. The recent HHS regulation, American Patients First, starts to get at this issue. This is terrific and needed for Big Pharma. But let’s not stop there. Keep going across all consumer facing healthcare services.

Another issue is choice, or in this industry, lack thereof. When consumers have choices, several things happen in a market. Quality goes up, prices go down and customers are happier. Think about it. If you are shopping for shoes, you can buy a pair for $5.95 or pay big bucks. Going hunting, yep the interweb has a sweet set of water-proof boots. Heading out on the town and need to step up your game but don’t want to pay for a name brand, you bet, the internet has that.

Sure, there are other variables negatively impacting healthcare, such as tort reform and who should own each person’s health records (I smell another article), but for now, let’s focus on these self-imposed restrictions.

The Solution:

So, how do you turn those barriers to a competitive marketplace centered around the consumer?

While I am typically not a fan of more regulations, the Congress will not act. And unfortunately, no health care organization is going to lead. I do like the approach this administration is taking on regulations: add a new reg, have to get rid of a few first. Would bet there are plenty of “value-added” regulations placed on the healthcare industry that could use the anesthesia mask.

Here is what I am proposing, with peace and love:

New Regulation:

· All incorporated entities providing consumer facing transactions for healthcare services and products; and government agencies providing health care services in the United States will be required to post online a clear description of each service (doctor’s visit and related services, diagnostic tests, surgery (including pre and post services, therapy, drugs administered as part of the care, etc..), prices for each described service, customer ratings, and scheduling availability.

· This information will be made available in machine readable formats.

· To maintain your license to offer services or sell products, your organization will have six months to comply with this regulation.

· If you are a health care service provider or healthcare manufacturer (pharmaceutical, medical devices, etc.) receiving payments from the federal government, you will not receive reimbursements for services rendered, if not in compliance with this regulation within six months of this regulation’s published date.

That’s it. Keep it simple.

As these healthcare companies post their services, prices, etc.. online, guess what… smart companies will then aggregate all these into easy to use websites and mobile apps where users can shop across different healthcare categories and services, prices, availability, and costs with or without insurance.

Free Market dynamics have worked in every other industry where they have been allowed to flourish. As a healthcare consumer, I think its way past time to let the free market flag fly high over the healthcare industry.

Just think how would the insurance market change for the better; with full transparency across all healthcare providers, Big Pharma and medical device manufacturers.

Something to think about the next time you need to go to the doctor.

Will leave you for now with this thought.

What company would fight this transparency initiative? Should some come forward with their airing of grievances, think about some sage advice passed down from a father to his son.

Great scene in the Godfather where an aging Vito tells a young Michael Coreleone “the first one to come to you about a meeting with Barzini is the traitor”.

About the Author: Keith Trippie

Keith Trippie is a retired Department of Homeland Security Executive, free-market entrepreneur and founder of GotUrSix TV (https://gotursixtv.io)