Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The Affordable Care Act is more of our broken health care model

Matt McCord, MD
Policy
June 22, 2013
Share
Tweet
Share

Every week we read another article on the fuzzy math and ridiculous mark-up for our routine healthcare. Do your own research; see Elizabeth Rosenthal’s article in a recent Sunday New York Times, the $2.7 Trillion Medical Bill or Steven Brill’s lengthy tome in Time, Bitter Pill.

We spend, and will continue to spend, more on healthcare than any other nation in the world and yet we are 38th in healthcare rankings according to the World Health Organization. America has the most efficient markets in virtually every other sector except healthcare.  Unfortunately, we are just beginning to see that our landmark health reform law, the Affordable Care Act, is no improvement and it will give us less for more.

America has had a broken model for our healthcare for nearly two generations (50 years). What is broken is our dependence upon 3rd-party middleman (government, insurers) when we need healthcare. Even though 70 percent of our health care is elective, non-emergent and provided outside of a hospital we allow middlemen to control all transactions.  These middlemen obscure all real pricing and insulate us from normal market dynamics and price-competition.  This prevents the development of a virtuous cycle between consumers (us patients) and providers (doctors, clinics, hospitals).

Thus, instead of win-win healthcare where individuals are paying attention to costs and are motivated to stay healthy (by saving money), we have lose-win-lose healthcare where everyone loses but the middlemen—have you ever noticed that there is always a crane in a hospital parking lot? Our poor collective health, with our obesity and diabetes epidemics, may be just one indicator of how decoupling the patient from their healthcare is a failed strategy.

America needs to move from an “open bar,” everything is covered and no one is paying attention to costs model, to a “cash bar,” consumer-driven healthcare model. Patients would pay attention to costs, have leverage for access to care (which will be important moving forward) and be incentivized to have healthy behaviors. Providers would be more correctly focused on the patient and be motivated problem solvers for the patient—providing higher quality and more convenient care.  This model for healthcare is more holistic and ethical too; by engaging and incentivizing the recipients of care it recognizes the interdependence of all stakeholders while giving patients and their families the ultimate choice of how their healthcare is managed.

America needs to think differently about healthcare and embrace a new consumer-driven healthcare model and paradigm: one that is decentralized, empowered, and collaborative.  It is no coincidence that the two most competitive economies in the world, Singapore and Switzerland, have such a model. Consumer-driven healthcare will make us more fiscally and physically competitive.

Regrettably, the Affordable Care Act is more of our tired and broken health care model; increasing 3rd party dominance, centralizing control, fueling unprecedented market consolidation. This has already increased our costs and decreased our choices and access to care.

Matt McCord is an anesthesiologist. He is founder, Michigan Alliance for Sustainable Healthcare, and can be reached on Twitter @MattMD.

Prev

Will health care price transparency help reduce costs?

June 22, 2013 Kevin 12
…
Next

Gun control: Whether the means justify the ends

June 22, 2013 Kevin 9
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Will health care price transparency help reduce costs?
Next Post >
Gun control: Whether the means justify the ends

ADVERTISEMENT

More by Matt McCord, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Why government cannot cure our health care

    Matt McCord, MD

More in Policy

  • How American medicine profits from despair

    Jenny Shields, PhD
  • What I learned about health care by watching who gets left behind

    Maanyata Mantri
  • How the One Big Beautiful Bill could reshape your medical career

    Kara Pepper, MD
  • Why the U.S. Preventive Services Task Force is essential to saving lives

    J. Leonard Lichtenfeld, MD
  • Brooklyn hepatitis C cluster reveals hidden dangers in outpatient clinics

    Don Weiss, MD, MPH
  • Why nearly 800 U.S. hospitals are at risk of shutting down

    Harry Severance, MD
  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 31 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The Affordable Care Act is more of our broken health care model
31 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...