I was so blown away by this article that I just had to share it with you. It’s called Where Is the U.S. Healthcare Industry Headed? We all know the answer and it is not good. But what amazed me is how much I wanted to vomit when I see Ivory Tower folks pontificating on how to fix the problem.

In this episode of “I don’t know what the f%ck I am talking about” is David Dranove who is Walter J. McNerney Professor of Health Industry Management; Faculty Director of PhD Program; Professor of Strategy. His opponent is Craig Garthwaite, Professor of Strategy; Herman Smith Research Professor in Hospital and Health Services Management; Director of Healthcare at Kellogg.

I am going to give some highlights from the conversation so the following is not meant to be contiguous:

DRANOVE: When I started my career, policymakers turned a deaf ear to health economists. And our classes at Kellogg were boring! We taught students mundane stuff like how to manipulate billing to increase revenue for their hospitals.

DRANOVE: One of the exciting trends I’m seeing, which I am also a little nervous about, is the growth of provider-sponsored health plans, where healthcare providers are forward-integrated into the provision of insurance, either by owning the insurance product or through joint ventures with existing insurance companies like Aetna and Cigna. 

GARTHWAITE: And United is not acquiring 100 physicians here, 100 physicians there. They’re acquiring thousands of physicians in places like Las Vegas and trying to roll out a new practice pattern in a large market. They employ doctors, but rather than paying them for services performed, they pay them to practice in a conservative, evidence-based way. 

DRANOVE: Other insurers have different models. Cigna has what they call a collaborative accountable-care model. Aetna has tried something similar. Cigna embeds its own nurses in the physician practices and works with Cigna data systems to inform the physicians about optimal care patterns. 

DRANOVE: You can also change scope of practice. We could allow registered nurses to prescribe certain medications, for example, and allow more folks to do things that they’re trained up to do, but which they are currently not permitted to do.

DRANOVE: Some of the reorganization that private-equity firms are doing is a possible way forward. Private-equity firms have been rolling up physician practices. Those are largely in a single specialty, usually primary care. 

To summarize:

• Bragging about manipulating billing to increase revenue for their hospitals.
• Salivating over provider-sponsored health plans owning the insurance product.
• Loving the fact that insurers are “acquiring doctors”.
• Being excited that Cigna embeds its own nurses in the physician practices to inform the physicians about optimal care patterns. 
• Recommending that RNs prescribe medicine.
• Getting the tingles because private-equity firms have been rolling up physician practices.

There you have it, my friends. It’s a draw between these two bumbling idiots. Direct Primary Care is not on their radar but be glad it isn’t. If you have not thought about DPC then you NEED to NOW! These are the “experts” who get so excited about the future of this healthcare debacle that they don’t need Viagra anymore. They just sit around the campfire and talk about Cigna and private-equity firms and doctors being pawns and they have one big circle jerk.

RUN.

RUN AWAY.

RUN AWAY NOW.