Benevolent Payor

Yesteryear’s healthcare pilot projects are inadequate for today’s problems.

More interesting ideas from Parkinson. Getting everyone in the pool is the first step. The next step is to put a structure in place that allows for private-sector experimentation in reimbursement and service delivery models. Guarantee issue and underwriting bans in the current bill open the door for this. It allows insurers to leave the underwriting game and focus on behavior change, incentives, and re-reimbursement/service delivery models.

jayparkinsonmd:

I just finished reading Atul Gawande’s latest article in the New Yorker, Testing, Testing: The healthcare bill has no master plan for controlling costs. Is that a bad thing?

He draws parallels to the history of agriculture in America:

At the start of the twentieth century, another indispensable but unmanageably costly sector was strangling the country: agriculture. In 1900, more than forty per cent of a family’s income went to paying for food. At the same time, farming was hugely labor-intensive, tying up almost half the American workforce. We were, partly as a result, still a poor nation. Only by improving the productivity of farming could we raise our standard of living and emerge as an industrial power. We had to reduce food costs, so that families could spend money on other goods, and resources could flow to other economic sectors. And we had to make farming less labor-dependent, so that more of the population could enter non-farming occupations and support economic growth and development.

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The government acted as a 20th Century platform to enable our farmers to do their jobs better. This is a perfect example of Government 2.0 existing in the 1.0 world…the government as platform.

I’ve been saying for quite some time that this should be the age of experimentation with the government acting as VC fund for hundreds to thousands of these pilot projects that foster disruptive innovation…