Skip to main content

"Novel...Health Plans Gain Traction"

Today's Wall Street Journal spotlights what I call hospital-sponsored "health insurance lite;"
"The programs typically involve collaboration between business owners, nonprofit groups and local hospitals, which offer enrollees a range of medical services at a reduced rate. The plans keep costs down partly by bypassing the extra costs that come with traditional insurance. That can be a big help for small-business employees who can't afford traditional insurance. But for patients with costly chronic diseases or catastrophic illnesses, the coverage would likely be inadequate.

In Galveston, Texas, the University of Texas Medical Branch hospital recently began providing coverage to more than 430 employees of small businesses at a cost to individuals of $60 a month, plus copayments -- far less than many traditional insurance plans. Nonprofit groups, including ones in Duluth, Minn., and Pueblo, Colo., have started similar programs. In Muskegon, Mich., one such program called Access Health currently covers about 1,100 small-business employees."
I've built (and, regrettably, disassembled) several of these plans over my career, living each time to fight another day and with a deeper understanding of what is meant by "Perfection is the enemy of the good" (a quote variously attributed to Voltaire, Flaubert and Joseph Addison, whoever HE is...)

True, the plans don't cover everything or address health care's every systemic flaw, but they're a start and it's heartening to see providers taking the lead. An idea that doesn't solve ALL problems may still be worthwhile if it solves a few.

The hardest part is convincing reticent providers that these plans don't really expose them to additional risk beyond what they'd have anyway, with uninsured, acutely-ill patients landing in their ER. Better (and far cheaper) to intervene early and sensibly.


Labels:

Comments

Post a Comment

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor...
Post a Comment
Read more

gapingvoid cartoon #378

Buy your own, here.
Post a Comment
Read more

"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information ...
3 comments
Read more