Well, can’t say they didn’t warn us. The Wall Street Journal recently printed an article entitled, Hospital Mergers Can Lower Costs and Improve Medical Care, by Kenneth Davis, the CEO of Mount Sinai Health System in New York City. It provides a clear view of the Brave New World of medical care if ObamaCare is allowed to proceed to full implementation.
No longer is an individual an individual when swept into the mega-hospital, mega-data machinery of population management medicine. Instead he or she is a member of a group for which “the hospital’s healthcare network will be paid a certain amount to care for a given population, and no more.” Let that sink in for a moment.
Dr. Davis blithely states this will incentivize providers and the hospital to keep populations healthy. What he doesn’t mention are the incentives to cut costs, withhold care, limit expensive care, and avoid the seriously ill.
Not to worry though, through large patient populations, “one can apply supercomputer resources to mine the data collected on them (patients) and create predictive models of disease.” For this data gathering and its applications to the patients we are told sophisticated electronic medical records and “an army of care coordinators to serve as the backbone of the care team” will be required. I assume the lowering costs part comes in the fixed medical payment allotted to care for that given population.
What a pity that Dr. Davis missed the rise and fall of the capitated HMO model upon which this population management model is based. The built-in economic incentives reward the worst instincts in all parties and places even CEOs in moral jeopardy. Physicians especially bear the brunt of the ethical dilemma, as ordering expensive tests or treatments could exceed the singular payment for that group of patients, in which case the physician’s remuneration is decreased.
Put another way, the physician’s salary is a hedge against loss for the hospital or insurance carrier. In the end the majority were not financially viable even with these perverse incentives. Of course this would be consistent with most things associated with ObamaCare, including the $1 billion spent on now defunct insurance exchanges that are being rebuilt at millions more taxpayer dollars-never admit that the concept is wrong, just the implementation.
It would appear that Dr. Davis envisions hospital CEOs in control of us physicians, who will be reduced to data gathering widgets, as well as our patients’ available medical care options, which will be derived from the meta-analysis of all that population data. This is the antithesis of all that is noble, compassionate, personal, and dignified in medicine and surgery. If November brings change to control of the Senate, this insanity must be stopped. We are destroying our healthcare system and with it the ethos of the country.