Grow up man! Thoughts on cooperating in ventures that are not necessarily to your liking.

“Please test us for ten days on a diet of vegetable and water.  At the end of the ten days, see how we look compared to the other young men who are eating the King’s food.”  Daniel, a Jewish prodigy, who was being asked to eat food that violated his conscience by his Babylonian captors.

You must have been in situations when you were younger when the classic phrase, “Well if you don’t want to play it my way, I will just take my ball and go home” applied!  Some of what I currently read and hear about Obamacare seems to fit in this category.  The only trouble is the game is going to go on whether you stick around or not.  So how should we respond when things are not necessarily going the direction that we want.

It might help to start by acknowledging that little effort to effect change had been made by the insurance industry to growing demands that a country as wealthy as the United States needed to find a way to provide medical care on some basis to all who needed it.  At some level access to ER’s provided this level of care to all, but in an extremely expensive and inefficient fashion.  Similarly, the very people who could least afford to pay for high medical bills, namely the uninsured, were often given the highest rates (analogous to “rack rates” at hotels that no-one ever pays, but which need to be posted for various legal reasons) when they went to medical providers.  This clearly was neither effective nor right.  All it did was penalize the honest among the uninsured into paying outrageous rates that no insurance company or the government would ever have considered paying for similar service.  That is if you can even call it “service” when describing what most uninsured find when they go to a medical facility!  We do well to remember that no-one (OK virtually no-one) chooses to be ill, even if their lifestyle does little to encourage health!

So having accepted some culpability for the current situation, we can then look at the best efforts of those who may be doing things in ways that we think are more designed to redistribute wealth than to genuinely provide for a better medical system, and ask ourselves, “What is there here to like and to cooperate with?”  I think that the answer to that is, “Actually quite a lot.”

As a physician myself, I know that most doctors go into medicine with high principles and noble desire.  Can’t we not all aspire to such genuinely good things as wanting to see all who need medical help being given that help?  This does not mean that we think they should get such help with no cost, or that they have no responsibility to have insurance in place.  Current plans to disallow pre-existing conditions are clearly ludicrous from a fiscal point of view.  Why would anyone ever bother with insurance if they can bolt the door after the horse has bolted, and still be reimbursed for the lost horse!  But this does not mean that we do not care about our neighbor who has lost his only horse!

Right now is the perfect time for those of us who think that the free market can provide better solutions in both the short and the long term to actually come up with some of those solutions.  If ever there was a time for bold thinking and brave actions, just as in the case of Daniel and his fellow countrymen in the Biblical example that I quote above, now would be that time.  Let me mention a couple of innovative approaches that I have heard people mention recently, that I hope actually see the light of day.  They may not be perfect solutions, but they could be great steps along the road to better approaches.

A retired Professor of Surgery  from the University of TX Medical School is working with some colleagues in the insurance and actuarial world to create an insurance entity that will be owned by the policy holders.  They have a number of very creative ideas to make sure that every part of the process from rates for policy holders to reimbursements for medical providers will happen in such a way that prices could end up being slashed compared to current comparable insurance programs.

Another medical colleague is working on providing a so called “medical home” to large numbers of people through an affordable concierge  approach.  How “affordable” will this actually prove to be?  I don’t know, but I am glad they are trying to find quality solutions that may lead to better medical care and quality access into the medical system.  The many examples  of doctors being available by phone or Internet would be further examples of innovation, as would the growing commoditization of medical care that is represented by medical tourism.

Even further out of the box are some extraordinarily successful medical sharing programs that are run with the wider Christian community.  Those who live in area of Pennsylvania with large numbers of Amish may be familiar with these sharing approaches.  But groups like Samaritan Ministries  and Christian Healthcare Ministries  have taken this to a much large scale and made them available to Christian individuals or groups all over the country.  Because these groups are protected under First amendment rights, they are unregulated by the various DOIs and so viewed with undisguised contempt by many in the insurance world.  But in fact they are specifically protected under the recent legislation, and in recent years have been shown to provide a very effective alternative to classic insurance models for those who are willing to shoulder the extra risk that working with unregulated models naturally entails.

The question is not are any of the examples given above necessarily more effective or somehow more “right” that models that are currently being forced upon all of us.  Rather the responsibility is on those of us who believe that the private sector can genuinely create a plethora of options to come up with ideas that will be shown to be both workable and compassionate.

So don’t take you ball and go home.  Rather get some balls (excuse the pun) and join in the fray!

About The Author

Bio for Dr. Tony Dale:  The old world doctor on the new world health care scene.

Quoting from Dr. Dale’s high school yearbook, it states, “For he has said it, and it’s greatly to his credit, that he’s an Englishman .”  Coming from a long line of physicians who trained at Barts Hospital in London, Tony and his physician wife, Felicity, moved to the United States in 1987.  Now, 21 years later, and with four grown-up children to prove it, Tony focuses on developing the work of The Karis Group, the company that he founded in 1996, to help provide access to quality health care for the uninsured and the underinsured.

The Karis Group is best known for the Patient Advocacy services that it provides to many DMPO and Limited Medical Benefit Plan (LMBP) members around the country.  Tony is a passionate defender of all people’s right to access medical care, and their subsequent responsibility to see that the medical provider is adequately compensated for the valuable services rendered.  Recognizing that there will often be a tension between the value of the services received, and the ability of any specific patient to cover those costs, patient advocacy from The Karis Group provides a professional and dignified way for members of DMPO and LMBP to receive the help that they need when out of pocket expenses are mounting and benefits are running out!

As well as his entrepreneurial activities with The Karis Group, Tony is also very involved in missions and church work around the world.  For more information on The Karis Group see www.thekarisgroup.com.