Money quote:
What people in Washington tend not to discuss, at least on the record, is the open secret that insurers are minimizing their forecasts of the eventual windfall they will enjoy from expanded coverage for Americans. UnitedHealth has given certain key members of Congress details about its finances and tax liability—both historical numbers and figures projected under various cost-sharing scenarios. But some on Capitol Hill are skeptical. “The bottom line,” says an aide to the Senate Finance Committee, “is that health reform would lead to increased revenues and profits [for the insurance industry]. … There will be [added] costs [to the companies], but we’re not sure the revenues and profits will be as low as they say.”
This is what happens with top down “revolution.”
Healthcare will only be “reformed” from the ground up. It won’t happen now, but it will happen in the next 5 years when people can’t afford the shitty healthcare currently being sold to them. There will be competitors who will do things better. They’re already forming on the periphery. I know many of them. And we’re all banding together. I’m hopeful because criminal greed never wins in the long run. There are plenty of doctors who want to do the right thing and truly improve the health of their population of patients. We have to organize them into local groups and give them the support and tools to start doing that. Then work with payors (likely employers or self-organized groups with large pools of co-op money) who want to simplify, simplify, simplify in order to deliver healthcare to a population of people at half the cost and double the quality.
In the beginning, it will follow the classic description of disruptive innovation:
- A new technology (or a cluster of new technologies)
- that enables a new business model
- that enables a new network of low cost suppliers
This new System will have “characteristics that traditional customer segments may not want, at least initially. Such innovations will appear as cheaper, simpler and even with inferior quality if compared to existing products, but some marginal or new segment will value it.”
And then gradually, it takes over the market and becomes commonplace.
I know it can and will be done.