Now, when I had mentioned this idea on my LinkedIn status I got a response of 'How is this different than Kaiser?' Additionally, the member of my network mentioned I should listen to the NPR interview with George Halvorson, the CEO of Kaiser Permanente. (http://www.npr.org/templates/story/story.php?storyId=106853465)
It was a fairly interesting interview, and it does seem to give a direction of where we could go. However, I still see Kaiser as an insurance company first and then a provider of health-care services. Hey, that is just my impression. I think there are some very good aspects, and I see it as a starting point. But, all things can be improved even if it is just a little or a lot.
The biggest positive of the Kaiser model is the NOT-FOR-PROFIT position of the company. This really puts the focus of the company on the true customer, wait for it, drum-roll, the patients and not stock-holders. The whole not-for-profit concept gives the idea (or illusion) that it is about helping people right from the get go. Also, my experience with Kaiser has shown me a company that is focused on using technology to improve the efficiency of the services they provide to patients.
Now, here comes the fun part. How can we improve it? I really think some of the ways are to try expanding upon the financial credit union model. The biggest idea would be to involve the patients as a part of the overall institution. So, as the credit union improves then so does your investment. The reward would be realize in lower premiums, when in doubt always impact the pocketbook to get a response.
1. What if a current financial credit union expanded into being able to offer health-care insurance? This could be an additional benefit of belonging to the credit union, having another option to gain access to health insurance. The credit union could offer their 'clients/ customer base' to a company that is similar to a Kaiser to achieve the group rate price which is so important to our current system.
If this was used, then you could also include a Health Savings Account as you method of paying for you health insurance and related expenses. In addition, this system could help to foster a sense of community between physicans, patients, and the the insurance company.
2. An underlying assumption to this concept is 'no person can be denied coverage'. This is such a cornerstone to any change that occurs. Based on this, it almost seems that a more radical change will be required. So, with that said I think we will need to have a separate type of entity for health insurance. I think this is the 'Health Unions'. An entire community would be included, and would pay into the system. Funds would be used to pay doctors, new technology, etc. Savings would be given back to the health union members in the forum of premiums that don't increase or maybe decrease. The use of HSA's would allow people to see their account funds increased, if they don't expense all of their funds. Here is where the overlap with a financial institution would be of benefit.
Again, there would be the underlying idea that people are only getting the tests they need. Or, doctors are no longer practicing 'defensive medicine' because of fear of lawsuits. Also, the shift in medicine would be to prevention rather than reaction. The pay structure for physicians would need to shift away toward something similar to Kaiser, where doctors get a salary. Almost forgot, I think it is important to say that we are focused on primary-care physicians, as these are the front-line warriors and who would be the ones that a majority of folks would need to deal with.
Ok, I think that is enough for now. The beauty of this issue is there is some much room and opportunity for discussion and real change.
Feel free to give me your feedback.
Interesting points, if I only understood better on how Credit unions work. What I would like to see is a insurance policy that would cover the type of medical treatment I choose to use. My body responds better with Alternative treatment ( Chiropractic, natropathic, suppliments or herbs vs synthetic drugs). Why can't I have my insurance cover these cost? they are much less expensive than medical and they are proven to work. So maybe we need to look at how health care is treated. We need simple and ruled based health care. Something we the patients can understand and be involved and have the right to choose, and not our insurance company. I'm the one paying for the policy, I should choose what I want it to cover, especially if its less cost. I don't get it...Ah yes!! A credit union that we the people owned which provided Health insurance could be the solution? Exellent
ReplyDeleteHi Thomas. David Grimes sent me over here. :) Interesting post for me. So my thoughts in no particular order:
ReplyDelete- Kaiser is a provider organization first and an insurance company second. I think they seem like an insurance company because you can't see a Kaiser doc unless you're insured by Kaiser, but inside the company, the provider side comes first.
- a credit union is a group of affiliated people pooling their money together to provide financial services. That is exactly what medical insurance already is. A group of affiliated people (usually people who work for the same company, but sometimes members of a union or other group) are pooling their money to cover the medical costs of the people in their group.
- The key element at issue is the increasing costs for us as a nation. We spend double what other western countries spend for less benefit. Getting everyone coverage may give everyone preventative care, but preventative care doesn't save money. The problem is the overutilization of care. And that problem is not on the consumers, it is on the doctors because they are the ones ordering the tests.
- I don't have time for much more right now, but some things to read: TheHealthCareBlog.com, and google Atul Gawande's New Yorker article from a couple months ago comparing McAllen, Tx and El Paso, Tx.
Thanks for starting the conversation
ps. don't get me started on HSAs and high deductible health plans... :)