Friday, June 24, 2016

Time to Brexit the Health Care System?


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Can't. Won't work. We're stuck with this. We have to fix it.


But “Brexit” was a great logo/hashtag/campaign meme, with echoes of “Britain, break it, exit” all in one. Falls right off the tongue, it does. And it described fairly exactly the mood behind it, one of breaking, getting out.


So in healthcare? Time to FFSexit - exit the fee for service business model. Nah, doesn't trip off the tongue. And it has echoes of “sex” and even “sexist.” Next!


Time to ITexit - exit the non-interoprative, non-communicative garbled EHRs and other information systems we have ended up with. Nope, nope. Sounds too much like inviting Texas to re-think this whole annexation thing.


Time to Vexit - exit the volume-based business model. Hmmm, no. Sounds vexatious, vexed.


Time to exit the fragmented, opaque, partial, byzantine, and outright cruel healthcare financing system we have now -FragOpParByzOutCrexit! Sigh.


Wait. Wait. Here's the core problem of this meme-pondering: We don't want to “exit” healthcare in any way.



The Congressional Republicans hope to exit the defined benefit Medicare system and make it a defined contribution system, presumably so that sooner or later they can drown the contribution in the bathtub. Republican state legislatures have found as many ways as possible to exit Medicaid, or its expansion.


But we the people can't exit the healthcare system because unlike political parties and ideologies, we actually have bodies, and those bodies need tending whether we like it or not.


The healthcare economy is hollow. You know the drill. It costs twice as much as it needs to for no good reason, overtreats to the tune of close to $1 trillion per year, at prices that have no real support in the cost basis or the market, still is a major cause of personal bankruptcies, and manages to cut vast numbers of people even people “covered” by high deductible plans, out of any treatment at all because it's so expensive to use the system.


We don't need to exit. We need to fix it. Fixit!



#healthcareFixit!

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