It really isn’t so surprising that health care costs are going up and that actual access to health care is going down. Good luck getting established as a new patient with a family doctor most anywhere in New Hampshire.
One overlooked cost center is the maintenance of a vast repository of health care buzzwords, invented by a coalition of the elite, which keeps the business of medicine just beyond the comprehension of most people.
These highly paid health policy “experts,” including academics, entrepreneurs, insurance executives, government contractors and assorted administrators, have little to do with patient care, yet they control how dollars are collected and distributed in our bewildering health care delivery system.
These folks, while providing great material for Dilbert cartoons, operate out of their C-suites and academic hideaways, working on ways to configure and reconfigure words and phrases to promote the illusion of progress and the pretense of original thinking. Health care lingo is like a whole new language developed by a random word generator.
Here’s what the “thought leaders” have invented in recent years. And bear in mind that lots of this gobbledygook is lifted straight from the mission statements of various statewide health institutions and policy groups. Policy decisions, payment issues, office personnel and even the practice of medicine within the exam room are dictated from on high, tripping up the practitioners who only want to practice medicine and advocate for their patients.
So, in the constipated verbiage of our grand health care visionaries: “Let’s leverage our patients and payers to maximize our synergies, so as to be catalysts for disruptive health care technologies. The path forward can only be illuminated by establishing a care-coordinating platform for sharing clinical population-based analytics in the cloud. Clinical Microsystems will do the real hands-on, value-added work by engaging, enabling and empowering health care stakeholders, thereby transforming big data into actionable information to support data driven decision making.”
Say what? But wait, there’s more.
“Doctors drive quality as we move from volume to value. Shared savings will be actualized by moving to high value provider networks, improving the bottom line as we incentivize wellness among our customers by using health coaches at our state of the art Centers of Excellence.” (Translation: Our doctors are too overwhelmed with paperwork and entering reams of data into the electronic record to see you, but don’t you dare see an out-of-network physician – and eat more salad and get your sorry butt off of the sofa.)
ACOs (Accountable Care Organizations), the stepchildren of enormously popular HMOs, promise fully furnished PCMHs (Patient Centered Medical Homes), complete with PBMs (Pharmacy Benefits Managers) run by TPAs (Third Party Administrators). At each of these levels, the metrics people will claim cost savings, without consideration of the substantial cumulative costs of their existence.
Despite the increased availability of health insurance under the ACA, premiums for some are way too high, and many people are too intimidated by the unaffordable co-pays and deductibles to actually use their benefits. Moreover, the provider networks are often outdated before they are even published, so who you gonna call?
Few among us truly understand our health care coverage, much less the obscure language that envelops it. Vaguely reminiscent of our fling with CDOs (Credit Default Obligations) and subprime mortgages, we blindly accept the language and intent of our dysfunctional health care system.
But, like taking in that cute, drooling, homeless kitten stumbling around in circles on your front lawn, one is left to suppress one’s concern about what could possibly go wrong.
Replace the “thought leaders” with thoughtful leaders, jettison the jargon and simplify the system. The real “disruption” in health care would be to provide each citizen of New Hampshire, and our country, with health care that is universal, comprehensive, easy to access and respectful of the patient.
It can be done.
(Dr. Robert S. Kiefner is a family physician in Concord.)