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Single Payer Is No Silver Bullet for Health-Care Reform

In my last article, I said that transforming health care in the U.S. requires an act of will, not an act of congress. Solutions exist today that can make health care better, faster and cheaper IF you make people responsible for their health-care spending and saving, empower them with better information and incentives, enable them with Web technology and offer global options.

In my last article, I said that transforming health care in the U.S. requires an act of will, not an act of congress. Solutions exist today that can make health care better, faster and cheaper IF you make people responsible for their health-care spending and saving, empower them with better information and incentives, enable them with Web technology and offer global options.

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One reader posted an acerbic response saying that these consumer driven health initiatives powered by Web 2.0 technologies were “nibbling around the perimeter of the problem” and the solution rests with a single payer model.

single payer versus payer healthcare

True, lots of people believe that the root problem is the payer model, and that moving to a single payer model (read government) is the fix. Maybe, but I have a question. Who is going pay for this multi-billion dollar health-care makeover with an economy crippled by a meltdown in banking, autos, and housing that is funding two wars (liberations… whatever) on borrowed money and a weak dollar? China?

Even if you find the money (search the Pentagon), how do you bring congress, insurers, hospitals, doctors, lawyers, and a myriad of special interest groups together to play nice? Bill and Hillary tried and failed. Can Obama make good? Maybe, but he’ll be fighting with one hand behind his back. Will the single payer model reform health care? Yes. Will it transform health care? I don’t think so.

Consumer driven initiatives powered by Web 2.0 technologies will work in health care because they work in banking, financial services, publishing, and retail, and they are ready for deployment now. As a consultant that works with health-care operators and systems in Asia and the Middle East, it is clear that governments in this region are moving away single payer systems not towards them.

obama talks to doctors

In the recently released McKinsey Quarterly (2009 Number 2), the big brains at McKinsey said, “The United States can take no single path to address the level and growth of every one of its health-care costs. If Americans are to become more value-conscious consumers of health care, reformers must therefore determine how to give patients the right information, decision tools and incentives.”

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Among their recommendations, McKinsey advocated the use of web, “infomediaries” to help consumers make more informed decisions around health-care pricing, quality, and services. They also suggested more effective financing and payment approaches with tools borrowed from the banking and credit card industries. And in a separate study on medical tourism in April 2008, McKinsey conservatively estimated that some 500,000 to 700,000 patients a year are medical tourism candidates from the U.S. and could generate $200 billion in savings.

Granted, a billion dollars isn’t what it used to be, but it’s a start, and that’s the point. There is no silver bullet to transform health care, but there are some transformational tools out there if we would only pick them up and use them.

Read more of Ruben Toral’s Medical Leave blog

Ruben Toral is Founder of Medeguide (www.medeguide.com) and President of the International Medical Travel Association (www.intlimta.org). He specializes in strategic consulting, branding, marketing and web platforms for the health-care and wellness industries, and is a recognized thought leader in medical tourism and health-care globalization. He is based in Bangkok, Thailand.

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