Directors Corner | June 2021 | On Being Free to Change Dysfunctional Healthcare Market

“Man is condemned to be free because once thrown into the world, he is responsible for everything he does.    Jean Paul Sartre

As a literature major in the turbulent 1960s, it would have been impossible to have avoided the French existentialistic philosopher and author Jean Paul Sartre.  “Nausea,” “Being and Nothingness,” and “No Exit” were the sorts of things that could keep like-minded college students up until very late.  Well, that and partying.   Oftentimes both.

One of the key concepts – common to all existentialists but most succinctly expressed by Sartre – was Satre’s famously ironic concept of “condemned” by freedom noted above. Responsible? For everything I do?  Oh man.  Not the sort of thing a college sophomore wants to hear.

In the unique, market-based healthcare model of the United States, it seems to me that a parallel concept – and perhaps even “condemnation”  inescapably (ala Sartre’s theme in “No Exit”) to purchasers – e.g., to employers, Taft-Hartley plans, and employer trusts.  Not as an undergraduate English or philosophy major but as a business major studying market behavior a few years late in grad school, this idea struck me then and still stays with me:

Having been thrown into (or having inherited) a market-based healthcare model where they are free to make all manner of decisions, purchasers in the US are responsible for everything we do – and for the outcomes that result.

That’s probably not what most HR people want to hear.  But when – in a market-based model – prices are unrelated to quality or even costs, when both prices and outcomes are so widely variable that within a few miles one hospital can provide better outcomes for cancer care at half the cost but isn’t rewarded for doing so, when both prices and outcomes are completely opaque for patients as well as referring physicians that they can’t make informed decisions, and when all the major supply-side players are making record profits while employees continue to see salary increases cannibalized by the high costs of care, where else should we look for a solution – and even place responsibility for that solution – but upon the people funding the system?  Who else but purchasers will change this?

To make this happen, we recently announced a joint purchasing initiative with the Purchaser Business Group on Health.  We think this effort takes the idea of group-purchasing and direct contracting to another level – creating an unprecedented opportunity for employers to improve the value-proposition being offered in today’s market place.

You can read about what we plan HERE.


Related Article: Colorado’s Governor Backs Employers’ Plan to Tackle Health Costs