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| "From Thy Bounty" (This has nothing to do with the story, it's just photo relief. Sorta like "comic relief", but not. Taken with my iPhone this morning.) |
Now hold that thought.
You may need it.
If you manage to make it through this entire story.
When he left the Air Force he took a job at Foundation Health (then HealthNet, now Centene) courtesy of the one and only Robert B., AF MSC (Ret). His background was mainly in hospital administration and he was pretty excited to be learning about HMOs. He was coming out of a closed, government health care system though and was pretty naive about new developments in the field. His AFIT sponsored MHA didn't corral his naivete' much either. Turned out he should have done a little more homework.
He had another potential job lined up as COO at an HCA hospital in McAllen Texas courtesy of old friend and grad school classmate Jon G and likely a third with the Kaiser system in LA. He thought he could return to hospitals later if he wanted so he and his family went to Sacramento and Foundation.
He had another potential job lined up as COO at an HCA hospital in McAllen Texas courtesy of old friend and grad school classmate Jon G and likely a third with the Kaiser system in LA. He thought he could return to hospitals later if he wanted so he and his family went to Sacramento and Foundation.
Not long after, he attended the annual American College of Healthcare Administrators meeting in Chicago (the last one he attended) and was talking with a classmate from the Medical College of Virginia at the alumni dinner there. He told the classmate he was working with an HMO and asked him what he thought. His friend said, "I think they are parasites on the system."
His friend was absolutely right of course and he wasn't savvy enough to argue at the time but they (HMOs) were/are necessary parasites...just like unions. They were necessary primarily because the AMA promised "voluntary cost containment" program of the early 70s wasn't working. That left room for entrepreneurs to step up and use purchasing power to drive hard bargains with physicians. Unfortunately, as health plans grew larger and stronger they became the problem rather than the solution, again just like unions. In the end, they become just another means to ransack our economy which has turned out to be more fragile than many of us ever thought it could be. It all turns on leverage and greed when we let it go unchecked...just like unions and banks and Wall Street.
The year 2023 will mark the fiftieth anniversary of the HMO Act - Will we like what we have created? Nah. Not enough rules and regulators to keep them in check plus, we have the "too big to fail" monkey on our backs.
Compare this to our great American pastimes of baseball and football - you are free to play with wild abandon as long as you stay within the rules and as long as we can see everything you are doing. Conversely, we don't have enough rules to balance HMOs, unions, banks and Wall Street.... probably not enough referees either...probably not enough transparency either. Not to mention the bigger they all get, the more clever they get at hiding crap so they can kick our asses when we are not looking.
Freedom and rules...you can't have one without the other.
It just goes against human nature to expect everyone to play fair all the time.
As you may have guessed his tenure at Foundation didn't last long. A couple of years later (after a great adventure helping start a program known as "TRICARE") he left to become a (Gasp!) healthcare consultant. A position that allowed him to spin his natural naivete' into "Expertise" and sell it for 25 years.
2 comments:
Not sure that the US will ever arrive at a decent health insurance solution. The problem is so complex that it takes a lot of solutions along the way to untangle it all. And everyone - literally everyone - has their hand in the till - so I don't know that we can trust health care reform to our politicians.
Guess that's why where here in Mexico - we go to a doctor of our choosing, negotiate fees and pay for services rendered. We also own our health record - literally. It comes home with us and we store it and share it with other doctors we might visit along the way. It's certainly not a perfect system, but the sheer simplicity of it keeps the costs down.
Thanks for the comments Charlene... I like your reference to complexity as it supports the notion of breaking it into smaller pieces to fix it, as in tort reform. But even then with so many "hands in the till" who knows if it can be done?
Your Solo Operated Health Plan sounds very efficient (Do I need to worry about you having some sort of catastrophic supplement though?)... I will send you a couple of chickens to trade for your annual check ups .
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