Tit For Tat: Health Care Consolidations Continue

There is news today of the demise of yet another independent physicians group. It seems they need the bargaining power of the large health systems to survive the payers pressure for ever lower reimbursements. Not surprisingly, the pace of provider mergers has pretty much been matched by payer consolidations.

In the S.E. Wisconsin marketplace where I do business, we're down to just a handful of mega providers and just as few payers (insurers). Did anyone get the upper hand in this progression? Are we on course for the ultimate consolidation to just one payer - the government? I'll bet providers will just love those fee schedules! And would health insurers be looking for new work?

Perhaps belatedly recognizing the folly of this arms race, provider and insurer websites are blossoming with information on price and quality. Have you looked recently? There are also nascent enterprises such as OutOfPocket.com - an independent health care transparency search engine - that will keep the pressure on. Think of a time when consumers have information and they (finally) make the market. The cycle of consolidations is likely to be broken and health care costs may actually come down.

Healthy Dining On the Fly

I clipped an item from the Wall Street Journal a couple of weeks ago about "the Calories Lurking in Restaurant Food" (Health Journal 7/29/08). There was reference to a website - HealthyDiningFinder.com - that proved useful just this week as I found myself looking for restaurants while on the road.


Believe it or not, you can enjoy a good meal and consume just 750 calories (or less) in the process. Check it out for yourself.

Health Care Referendum: Let's Try A Little Truth in the Wording

There have been reports in recent days about a group collecting the required signatures to get Advisory Referendum on ballots in Oshkosh, Eau Claire and Douglas County; now Oak Creek and South Milwaukee have joined this "statewide movement".

Following is the language of the resolution being promoted by Citizen Action of Wisconsin: "Shall the state legislature enact health care reform legislation by December 31, 2009, that guarantees to every Wisconsin resident affordable coverage as good as what is provided to state legislators?"

Wisconsin has one of the lowest rates of uninsured residents in the entire country and under Governor Doyle's leadership, Badger Care was expanded this year to make health insurance more easily accessible at low cost to virtually every child in the state. The Citizen Action "movement" is simply a thinly veiled attempt to promote the "Healthy Wisconsin" Senate Bill that failed to advance in the last legislative session. Apparently these folks think it a good idea to try and mandate the most expensive (state employee) coverage and then pay for it with a huge new payroll tax on all employers - a tax that would more than double insurance costs for most in the private sector. Where would this "feel good" movement be if the Board of Directors of Citizen Action included the businesses that would have to pay for it?

Without a little truth in the language of the referendum, I suppose a gullible public fed up with high health care costs will 'vote' their support of this measure. Heck, I think we should also vote for $2.00 a gallon gas and "a chicken in every pot"!

Coming Soon; Another New Hospital Near You!

Here in the Milwaukee area - as is happening all over the country - we learned yesterday of plans for yet another new hospital. The news reports centered on the need for another facility and the impact on costs. Perhaps a more pragmatic view of this news would be beneficial.

The notion that the best hospital is always the nearest hospital is laughable. And yet in an emergency, when you call 911, the chances are the local fire department responding will only take you to the nearest ER. Wouldn't it be prudent to be better rehearsed for such an event? Say I have an acute heart attack. On the one hand, the local fire responders could take me to a hospital only 8 minutes away but then I might lay waiting for the 'on call' team to arrive; a team that might be only slightly experienced to treat my condition. A better scenario might be to call a private ambulance company that drives me an extra 15 minutes to a facility equipped 24/7 to give me the best care possible. Despite the extra drive time, I could actually receive care faster and from a better team of experts.

Convenience is great when it comes to fast food restaurants or drug stores. But when you need critical hospital services should convenience be anywhere near the top of your selection criteria? "Shopping" for health care when you are unconscious strapped to a gurney is unlikely. But why can't you do your homework now? It could save the life of you or a loved one.

A Health Care Tidbit from the Czech Republic

Visiting his home in Milwaukee, U. S. Ambassador to the Czech Republic Rick Graber spoke at my Rotary Club this noon. He talked about his experiences in nearly two years of service in Central Europe. Jumping around to touch on several topics, of course my antennae were most sensitive to his brief remarks about health care in this country of about 10 million residents.

To paraphrase what I think I heard: health care in the Czech Republic is 'free'. It is interesting however that they - like the U.S. and most countries - are struggling to deal with rapidly rising costs. Up until recently, there had been no cost for receiving care and so, the average Czech sees his/her doctor 16 times per year. "There's no charge, so why not; it's like a social event", Ambassador Graber reported. Faced with such (over) utilization, they are now trying small co-pays; a koruna per office visit. FYI: the currency of the Czech Republic is the koruna which converts at about 15.1 korunas to the dollar. It would surprise the heck out of me if a 6 1/2 cent co-pay had any impact on costs and yet the Ambassador reported the citizens are in an uproar over the new charges!

Interesting, isn't it? I've referenced a P.J. O'Rourke quote before but it bears repeating here: "If you think health care is expensive now, wait until you see what it costs when it's free!"