I have attended more scientific and medical conferences than I care to remember. One thing that never failed to impress me was the large number of foreign-born young scientists attracted to our country and our great universities. Many of those scientists arrived as students from countries that smothered independent thoughts and initiatives, and chose to stay in the country where freedom reigned and the possibilities were unlimited. But then 9/11 happened, and our country was seized with a dark mood of suspicion and outright xenophobia. Young students and scientists could not join our scientific enterprise, to our great detriment. What we lost was the great intellectual cross-fertilization that animated our progress. The rise of xenophobic obsessions, coupled with hostility toward Science by the Bush administration wrought incalculabe long-term harm to American science. Yes, we are still garnering a lot of Nobel Prizes, but don’t let it deceive you -those brilliant scientists are awarded their respective prizes for work done over decades, during the golden age of American science.
The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs.
Last week Anna Wilde Mathews at the Wall Street Journal published a nice piece that detailed the difficulties employers and consumers have getting meaningful health care data from health plans. As the article describes, that lock has been pried loose a little as a result of competition from health care data vendors like Castlight, Thomson Reuters and Healthcare Blue Book.
The health plans, particularly, are loathe to release any data that might reveal their pricing arrangements with providers, and they’ve used the protection of this proprietary information to justify continued data opacity, even though that information could be helpful to their employer clients and members as they try to cost-effectively negotiate the labyrinthine health care system.
We’re in a regulatory environment that has been neutralized, shaped largely by the organizations that would be regulated, and which, if it promotes transparency at all, does so grudgingly and with hurdles. Witness the open letter to Don Berwick, MD, CMS’ Administrator, by Bruce Boissonnault, the savvy, experienced CEO of the Niagara Quality Care Coalition in New York, decrying the tremendous barriers CMS has established that thwart organizations trying to access and analyze Medicare data.
Meanwhile, legacy health care organizations that work to maintain artificially high cost through protectionist maneuvers are really creating market vacuums that, in economically stressed times like the present, are highly susceptible to attack. We see this in the efforts of the health care data firms, and in my own onsite clinic/medical management sector, where we’re driving down cost significantly at the expense of the status quo. In the absence of public policy that is in the common interest, the market may not be as capable as we’d like, but it can sometimes be effective.
In other words, change is inevitable here, and soon.