Wednesday, December 06, 2006

Personal Responsibility for Health Care Spreads to Patient Records

Patients from 5 major companies will be given an additional responsibility for their health care, updating and distributing their medical records to those needing access. This move comes on top of rapidly growing responsibility for paying for health care services by individuals in the U.S.

President Bush encourages employers to reduce their health care insurance coverage by switching to high deductible health plans. Many are taking him up on his suggestion. Meanwhile the government “modernizes” Medicare and Medicaid which means offering fewer benefits along with higher deductibles and co-payments. Both business and government plan to shed people from their health insurance rolls via these strategies, leaving more people on their own for care.

Select patients will have the added responsibility of schlepping their electronic medical records as they make their way through the health care maze. Assuming they have the funds to meet the deductible as large as $5,000 and any required co-payment, their provider will have access to comprehensive information about their patient (assuming they haven’t excluded it from their record). Those who can’t meet the financial hurdles in non-emergency situations will sit in pain at home with the comfort of having a Personal Health Record.

The company offering this service to employers wants to remake the health care system. It is the executive’s second time predicting solutions to the ills of America’s health care non-system. In the late 1990’s J.D. Kleinke viewed physician/hospital partnerships as the answer. He cited Columbia/HCA’s model as one that could cure the ailing beast. He still pushed this view in an interview nearly two years after Columbia/HCA imploded from within. Our local physician hospital integration in San Angelo, Texas is in the midst of a nasty divorce adding another nail to J.D.'s "solution".

Mr. Kleinke backed away from this prescription and now offers the universal personal health record as the salvation. He believes implementing this on a nationwide scale would save significant dollars. While his theory may be correct, it faces several problems in the Bush world. The current administration likes volunteerism vs. imposed regulations. A quick look at the system to track animals suffering from Mad Cow Disease reinforces this preference.

The two major insurers in America are employers and the government. Employers are well into an 8 year dance of covering fewer people with just 59% of the total population now covered by their employer. Government is about 3 years into imitating business by shifting more responsibility to individuals for the cost of their care (this includes the poor). Meanwhile 46 million people are without health insurance altogether.

Mr. Kleinke’s approach is to build from the employer side first. His company faces strict competition for government business given President Bush’s preference for rewarding insiders with federal contracts. As J.D. noted many of the personal health record companies are funded by “private investment capital”. Omnimedix has an uphill climb given Bush’s record of covering for The Carlyle Group post Hurricane Katrina and designing Medicare Part D to help board member Uncle Bucky’s Wellpoint. In the last 6 months The Carlyle Group purchased MultiPlan and PHCS to help employers and the government cut health care costs.

Where will Omnimedix fit in as the Bush health care cost dump to individuals continues? How will J.D.’s personal health records roll out to the ever growing legions of uninsured? There is a market many don’t want to serve and the few that do face ever growing financial constraints in their ability to provide care for all who need it.

While J.D.’s idea sounds great, it likely is just another punch in the Bush health care blanket party. He’s right we need a coordinated, capable, properly aligned system. There just isn’t anyone willing to provide the leadership to make that happen…

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