The Healthcare List


Oh hey – did you notice the subject line of this email?  From this point on, the ROND Newsletter will now be known as the ROND Report

While all you finance folks, CEOs, lawyers, accountants, etc. put up a valiant effort, it’s not surprising a marketing professional won.  Credit for the name goes to Chase Ezell, VP of Marketing Strategy at Golden Spiral.

Thank you again to everyone who participated. This was a lot of fun.

Now, to the newsletter:

Topic of the Week: The Healthcare List

I received feedback asking for commentary on specific industries. You people need to be careful what you ask for. 

To dip my toe into an industry newsletter, I thought I would start with the $3T elephant in the room, healthcare.

There is just one problem. Healthcare is a very political topic.

I promised myself I wouldn’t use ROND’s blog or this newsletter as a platform for broadcasting my political beliefs. It’s not like I’m going to change anyone’s mind.

I almost wrote about something else, until I watched the season premiere of Game of Thrones.

First of all, I think we can all agree Arya Stark is awesome. She’s had many powerful people do terrible things to her, but instead of accepting her fate, she’s taking action.

She’s working her list and taking down the underlying drivers of her pain.

For those of you that don’t watch the show, Arya is a medieval ninja. She has a mental list of all the people who have slighted her and is currently (and quite efficiently) in the process of eliminating all of them.

Today, I’m creating a list of my own. The Healthcare List.

What is the Healthcare List?

I think everyone can agree the healthcare system in the United States is too expensive. That statement shouldn’t be political. It’s a fact.

This list contains the real culprits behind why the US healthcare system is so expensive. If we want to “fix” healthcare, we need to eliminate all of these. Here’s the list:

Supply is artificially inhibited: Regulations and lobbying power make it harder for new players to enter the healthcare market and survive. (I may be teetering on political here.)

Demand is growing: Our population is getting sicker and increasing use of medical services (sometimes overusing).

Healthcare costs are pulled out of a magic mystery box: No one knows what things cost.

Consumers are complacent: We have limited organized movements protesting the above issues.

What do We Kill First?

I vote for consumer complacency. You have to get the people engaged on fixing the underlying drivers of healthcare expenditures before anything else moves.

Even if you decreased the current rates of disease, it wouldn’t change the fact that healthcare is expensive to begin with.

Even if you had full pricing transparency, that wouldn’t drive costs down to where they need to be. You need new folks entering the market to force competition and lower prices.

Judging by what we’ve seen for the last 50+ years, politicians in the US don’t focus on reducing barriers to entry for healthcare. They have no incentive today to do it. (Sorry, that was definitely political, and I was doing so well.)

I don’t see any other starting place besides consumer complacency.

Who Didn’t Make My List?

Lack of interoperability: Having information in more than one place is not an underlying reason for why healthcare is so expensive.

Fee for Service: Every other industry in the world is fee for service and manages to do just fine. Value is in the eye of the beholder, not a report you file with the government.

What is and isn’t covered by insurance: If healthcare was less expensive, it wouldn’t matter what’s covered.

What do You Think?

If one of you has some free time on your hands to inspire and mobilize the masses, I think the rest of us would greatly appreciate your efforts.

In the mean time, I want to hear your feedback.  Who needs to be knocked off first? Did I forget to include something on the list?

About the author

Danielle O'Rourke

Recovering Investor. Mom. Wife.

1 comment

  • Great list, Danielle. Worthy of the Iron Throne. I would add to your list Clinical Variation and attack it first. Reducing variation in care delivey has a dual benefit. It promises to improve quality by moving providers and clinicians towards evidence based therapies. It also reduces cost of care in two ways. First and most importantly it would eliminate ineffective and unnecessary care. Second, it would improve provider purchasing power for effective supplies and devices. What do you think?

Danielle O'Rourke

Recovering Investor. Mom. Wife.

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