All of the special interest groups around healthcare have more or less tolerated each other over the past 50 years. Why? The healthcare pie has steadily grown over that time to almost 20 percent of our gross national product. This year seems to be the year that our society says this is going to stop. If the pie does not grow, each interest group will fight to the death over their piece of the pie.
Many of these groups recently went to Washington to pledge their support for change. The only agenda they really had was to be able to bring their knives and forks to the dinner table.
- Employers want their healthcare costs to go down, or, at least, to shift to the government or union trust funds. (Does anyone really trust those trust funds?)
- Pharmaceutical companies want freedom to market in a system with neither competitive nor regulatory control of their pricing or operations.
- Physicians want no accountability over their practices or fees.
- Politicians want more power over a large sector of the economy and increased tribute in the form of campaign contributions.
- Democrats hope to use the issue for single party rule for years to come.
- Republicans hope to use the issue to get back in the ring and become relevant again.
- Hospitals seem most concerned about profits and reimbursement.
- SEIU and other unions see this as the time to grow unions exponentially in the healthcare arena. (Perhaps they can do for healthcare what the teachers union has done for urban education or what the auto union has done for the auto industry.)
- Health insurers want to continue to pay less for healthcare and make a profit by avoiding risk and adding unnecessary services they will provide
in the name of controlling cost.
This food fight will not be pretty. What are missing are two interests: what is best for patients, and what is best for the sustainable economic health of our country.
Let us hope that our not-for-investor voluntary healthcare sector can fight for those two interests. We need change. But responsible change will only come if community-by-community “we the people” start getting involved.