Perhaps it is the political season that has dulled my senses. The South Carolina Republican Primary has just ended and the pundits have talked non-stop. My ears are tired. Parsing the nuances of exit polls can begin to sound like gibberish. And that is before we even consider the cacophony of the umpteenth televised debate. Its just talk, talk, and more talk.
And the same could be said about all of the various players that are preparing for the implantation of the Affordable Care Act (ACA) in 2014. Daily, our government uses our tax dollars to remind us of what wonderful benefits the coming healthcare reform will bring. A press release-a-day from the Centers for Medicare and Medicaid Services (CMS) informs us of a new aspect of an already implemented component of the ACA. Selected groups of citizens extoll the benefits of CMS’s regulatory fiat. Forget the billions of dollars it has already cost, it will help you. Just trust me, they say. Some truth. But a lot of talk.
What about the hospitals? What are they talking about as 2014 approaches? Of course, they are preaching how only they can really improve access, increase quality, and cut costs. Only they can serve as the senior partner of these new accountable care organizations (ACOs) that will create the vehicle for saving so much money for the government that good old Uncle Sam is going to “share” the savings with them. Forget the fact that a five year pilot of ACOs failed to demonstrate expected savings, and that the hospital is the most inefficient and most expensive venue for healthcare services. The tiger will surely change its stripes?
Talk, talk, and more talk.
Are the big insurance companies quietly watching? Don’t bet on it. After years of hammering the doctor’s pay, the payers now realize what they have done: created a fire sale of primary care practices to the big hospital systems. In response to this threat of being marginalized, insurers are saying, “Wait a minute, we are the ones that can improve access, increase quality, and decrease costs. Just give us a chance.”
As Highmark Inc. of Pennsylvania is reported to have said last week in defending its purchase of a hospital system, our “strategy includes establishing an integrated health care delivery system — including hospitals, outpatient centers, physician practices and insurance — that will promote “innovative care models and lower-cost sites of treatment.” Of course, Highmark also announced a $38 Million upgrade of the hospital it just bought: costs that can only be recovered by filling up expensive hospital beds. No conflict there, right?
Talk, talk, and more talk.
What about the doctors? Can they talk with the best of them? Perhaps, but with over fifty percent of the primary care practices already selling out to their hospital system or some corporate enterprise, most have already been muzzled. With the fear of failure gripping the fifty percent of independents remaining, the noise they are making is a song of survival rather than the save the world rhetoric cited by the power brokers.
Physician Care Direct eschews the talk, talk, and more talk. Hopefully our actions will speak loudly.