The Compound Fracture of Healthcare

Interesting times tend to yield controversial dialogue in a business publication. This edition of Ingram's is not only a bit edgy--but it is also arguably conflict-oriented throughout. While not "beefy" in weight and page count, I think you'll agree that this issue is heavy in content.

While at deadline producing this edition, an interesting thing happened at our office. As you read the Healthcare Industry Outlook you'll understand the irony. An associate's baby sitter called reporting that his 19-month old daughter hurt her arm. While it wasn't catastrophic, it was worth a check-out. The associate's spouse called over the course of the next few hours with a progress report. She reported less about their daughter than about the difficulty of finding help.

Her first destination was to the pediatrician/family practicioner who was of little use. The next was a call to an orthopedic surgeon who offered to take a look two weeks hence. This was followed by a 20 mile jaunt to the ER of Children's Mercy, a bit of a standard industry wait, and the diagnosis of a fracture. Fortunately a splint was provided, but the appointment for installing the cast remains a week or more out.

The problems facing the nation on the health care front are daunting. In this issue readers will hear more candid conversation about what those problems really are than they will in a lifetime of watching network TV.

Readers will learn about the changing face of the uninsured--they are no longer the poorest of the poor, not even close. They are often risk-takers, people who choose the things they know they need or people who are unable to qualify for coverage due to the fact they don't belong to a larger group. The fastest growing group among the uninsured are those who makes $75,000 or more a year.

Readers will learn too that the expansion of area hospitals is not necessarily a sign of prosperity but a pro-active effort to provide a rapidly aging population with the level of service they have come to expect and demand.

This combination of factors has led to a relentless increase in healthcare costs, which, in turn, inspires more people to give up health care insurance and forces the rest of the population to absorb the unpaid costs.

The high level of competition in Kansas City has ironically meant a lower level of reimbursement for Kansas City providers. Malpractice rates here are disproportionately high and this, combined with lower reimbursements, has led to real decline in physician incomes and a consequent attrition among the physician population. Given the universal shortage in nurses and techs, the growing doctor drought adds one more burden on the Kansas City healthcare market.

The challenge that faces healthcare providers and the business community in general is how to solve these problems before we drift to a future that almost no one in the healthcare community really wants--and that is a nationalized single payer system along the British or Canadian model.

If Kansas City is the test market to the nation, would it not be appropriate for us as a community to devise a plan that would rescue American healthcare from its impending crash and burn.

We would not be in a position to execute such a plan in whole, but perhaps we could recommend it in whole to national authorities and execute one in part with the help of local ones. This would seem a likely pursuit of a small, select group, sponsored perhaps by the the Kauffman Foundation or a noble organization of the like. The mission of this group would not be utopian, merely practical.

Who knows--with some collaboration, a dose of inner-industry reasoning and an understanding among healthcare service users--we might just figure out a way to diminish the healthcare run-around and get the industry back on its feet.

Editor-In-Chief & Publisher
jsweeney@ingramsonline.com