As I enjoy celebrating our Nation’s Independence Day with family and friends over cookouts, stories, and fireworks 💥 I look back at the events leading up to the ratification on July 2, 1776.
I cannot help but think how it may be a vision into the next few years of healthcare. For the past hundred years, the population of the United States has viewed their healthcare as good. Many would say it has been prosperous, great, and some of the best in the world.
Since the industrial revolution, many of the people in the United States have had insurance through their employers. This “benefit” of employment has led to healthcare as being a topic of out of sight out of mind.
In the last 10 years through politics, economics, cost pressures, Wall Street, media, and the impact of the baby boomers on social security healthcare has become an ever increasing hot topic.
Similar to the events leading up to our nation’s Independence Day that occurred between the years of 1763–1776 I have a suspicion that the same is happening to the topic of healthcare.
Instead of colonists, today it is the unfairness being felt by people as patients.
From former political leaders who have benefited from their offices and post-office publicity to earn millions, to those that have benefited from the “reap what you sow” medical industrial complex, to the insurance companies who continue to make billions of dollars by pooling their risk amongst covered lives people (as patients) are starting to ask questions.
The reality is that 10 years ago in 2006 there were less than 5% of the population that had to pay more than $1000 out of pocket towards a deductible. In December of 2016, that percentage rose to greater than 54% of people in the Unites States had to pay more than $1000 in out of pocket deductibles.
This number is only going to continue to increase in the next few years.
Policy makers, insurance companies, and healthcare organizations feel that by shifting more of the cost responsibility that people, and the patients they become, will begin to make different decisions about their healthcare.
They believe that people and patients will choose lower cost options, seek out preventative health programs, participate in screening programs, and make smarter choices about their overall health habits.
This reminds me of how the British found the colonists unwilling to pay their fair share in the administration of the Empire. After all, citizens residing in England were paying more in taxes than those living in the American Colonies at the same time.
What I mean is that there are many families in the United States today that use 30% or more of their income to pay for health insurance.
I am willing to bet that none of those families make a billion dollars in annual revenue, let alone are in the top 1% of earned income in the U.S. So while those same insurance companies and policy makers may be subjected to 38% in taxes, their cost burden for healthcare coverage is not the same.
People and the patients they become do not want to be subjected to modern day taxation without representation. Or in this case, taxation without access, coverage, and benefit of healthcare.
People, and the patient they become, also do not want to be watched over like children (similar to how the colonists felt).
People do not always want to be preached at, pontificated to, or made to felt guilty for having a slice of pizza, a piece of cheese on their burger, a can of beer with their families, or lighting a firecracker (let alone did you walk your 10,000 steps today) to celebrate our Independence Day.
I mean, this is what being an American is all about, right?! Freedom of choice?!
People as patients also do not want their grievances to be ignored. Whether it is a patient in rural Montana that has CHF, a patient in Pittsburgh diagnosed with cancer, a person in Florida living with mental health, a person dealing with obesity in Green Bay, or a child needing to see a pediatrician in their local community, patients want to be heard.
People as patients do not want to be a number. They do not want to be a cog in the wheel. They do not want to have to wait only to have a mere 7 minutes with their physician only to be told to take 2 pills and call me in the morning.
People want to be heard. People want to connect. People want to know that they can access the healthcare system. People want to trust their physician and know that she/he are listening, understanding, taking their time, and are going to work as the patient’s advocate.
Patient’s do not want to wait 2 weeks for a bullshit Press Ganey survey that they are not sure who it pertains to, let alone what department in the hospital. Patients do not want to have to wait for ‘being heard’ weeks later. People want to be heard today, now, in the moment.
As the politics of healthcare continue to crystallize in Washington, D.C. and the economics shift from employers and insurance companies to the employees and people as patients, the questions remain when will the patients and physicians band together in the ‘religion of medicine.’
The medicine that focuses on one patient and one physician at a time. A medicine that cares more about the art of healing and solving than it does the business of ICD-10, DRG’s, and CPT’s. A medicine that focuses on listening to patients and delivering the right care, at the right time, for the right patient, based on the right diagnosis.
On this Independence Day, I am declaring my own independence in healthcare.
I will continue to challenge the status quo. I will leave the political correctness at the door. I will give a voice to those that do not speak the healthcare language. I will listen to understand. I will design to meet the users’ defined needs. I will debate, poke, probe our so called healthcare leaders when I smell bullshit. I will continue to be transparent in my communication. I will debate.
I will deliver an Independence for all patients. One at a time.
I deliver care at the N of 1.
Happy Independence Day.