An opinion piece from the N.Y. Times that details the evolution of HMO's in to Accountable Care Organizations or ACO's. Accountable care organizations will shift the focus of medicine away from treating sickness and toward keeping patients healthy. While these organizations when managed well really lower costs and provide better care, they also demand accountability from patients to a level where some of us would be pretty uncomfortable. The vast majority of people will actually like this system though since it not only provides a Medical Home but also focuses on avoidance of sparks rather than the full fire engine approach which we currently use.
OPINION | January 30, 2012
Ezekiel J. Emanuel: The End of Health Insurance Companies
By EZEKIEL J. EMANUEL and JEFFREY B. LIEBMAN
The article, written by non physicians, assumes somehow that physicians will actually be in control rather than bureaucratic folks. I doubt this supposition. I also believe that after Obama is re-elected that he will force this business model with the support of most Americans. The model does make sense medically, and better care for lower costs is a positive goal.
The issues that are ignored by this article and will be obfuscated by the government are many. The payers will be large companies and our government. To what level will those paying the bills have influence over your care? Will the harm of tort ever be addressed? How will invention in the areas of Pharma and technology proceed as these drive costs up?
Much more importantly, when the mandatory monitor in your heart signals your primary care masters that you've been non-compliant with your anti-hypertensive regime what are they going to do? Should they listen to your stories about fatiguing side effects combined with ED or send a tech to your house to administer daily involuntary injections. We're all in this together you know.
Edit. Richard Stewart has pointed out that Ezekiel Emmanuel is indeed a doctor. He is an M.D. Phd and is the brother of Rahm "sharp elbows" Emmanuel.