RedScrubs
The Resource for Medical Professionals

CEO Kenneth Melani of Highmark Inc. and Joseph Frick of Independence Blue Cross stated that “consumers need a dose of culture change to understand that the cost of health care is more than just a $20.00 co-pay”.

Melani and Frick believe that the merger of their two huge companies would create Virginia’s largest health care provider giving them the funds to educate consumers that they have a stake in controlling costs. “Health care costs continue increasing dramatically and the unaffordability of health care today greatly concerns us” they said.

Highmark and Independence said their combined size would allow the new company to hold administrative fees flat for two years, better manage prescription drug costs, and to provide more than $650 million to help expand health care access to Pennsylvania’s uninsured through subsidized lower cost insurance.

It must be nice to have the salaries these CEOs have. And then, to assume the common man does not know already how ‘out of sight’ health care costs have become? Yes, we are aware we have a broken system. And then to assume it is the customer that bears the brunt of understanding what healthcare has to offer us? Why not spend more money educating clients how to take care of themselves, their chronic illnesses and in prevention? How, in one press release can we decide what is wrong with our healthcare system and that one state is going to fix it with a merger?

Several lines of the page in all sorts of media have been devoted to the evaluative concepts of healthcare organization ratings and physician provider ratings. Many websites dot the web with such databases for patients of all types to delve into and either look for a new provider or submit a subjective evaluation based on their most recent healthcare experience.

The June 10th health section of the New York Times caught my eye with an interesting piece describing a pediatrician’s difficult decision to “fire” a patient because of the poor relationship between the provider and the patient’s mother. Clearly not a daily occurrence in the healthcare world, but it does happen and we all know many patients that have switched “fired” their own doctors and have obtained new ones.

Some potentially great news for patients with hypertension some time down the road as long as the clinical trials go off without a hitch. Investors seem to be pleased with the preliminary results and so does the stock market. However this is what healthcare has become, this is the beginning of one of the many ailments with our current healthcare delivery system - Investor interests.

Third party payers such as Medicare and Medicaid as well as privately based insurers need to refocus their attention on what is in the best interest of the patient. In an attempt to force industry change payers have restricted their reimbursement rates, increased premium costs for patients and employers, and developed lists of medical conditions that they [payers] feel are avoidable and thus will not provide any remuneration for.

A new level of healthcare transparency is being implemented in Ohio at Alliance Community Hospital where it is paying patients $100 for their hospital bills and explanation of benefits (EOB). The information is put on their web site comparing themselves with other hospitals for patients to view. The goal as reported in amednews is to provide prospective patients that typically use competing hospitals for healthcare services to come over and use Alliance’s healthcare system.

Wal-Mart jumped into the healthcare arena with their retail clinic program called Convenient Clinics to provide improved access to care earlier this year and towards the end of last year when many media headlines broke the story of retail clinics. There was an immediate flurry of activity with store chains such as CVS in the Boston, MA area where some 2000 of these clinics were to be established over the coming months and year (2008).

In the age of an ill healthcare system can small business owners survive without offering health benefits? Small businesses have been hit hard by rising healthcare benefit costs, with more and more small business owners canceling their health benefit coverage for employees because of the added costs. SurePayroll conducted a survey of small businesses recently in the Midwest which outlined the disparaging numbers of small business that can’t afford to offer health benefits to employees.

Establishing health insurance providers as non-profit entities is an interesting concept in today’s healthcare system. What would happen if the multitude of health insurance companies switched status from for profit to a non-profit status? Putting away multi-million dollar compensation packages for industry executives and replacing them with premium dividends and improved coverage for members, could it really happen?