Category: Healthcare Reform

The New-Economy has Created a Trade Deficit in Small Cities and Towns. Healthcare Spending is the Bulwark

I recently drove through Lewiston, Maine.  It’s no longer the flourishing city it once was, though until the early 20th century Lewiston (seen in the drawing above) was a booming American mill town.  Its factories, hydro-powered by the Androscoggin River, were linked by rail to Boston and other large cities.  Like many mill towns in New England, ...

On the “Bay State Boondoggle”

The Boston Globe recently ran an article discussing layoffs at Baystate Health, a large health system in Western Massachusetts.  The system is planing to lay off 300 employees to try to close a $75M deficit.  According to the Globe, the deficits are mainly driven by declining Medicaid reimbursement, but, more interestingly, by a $23M hit to Medicare revenue ...

Healthcare’s “Modern Movement”

For most of my childhood our next door neighbor, Nick, ran a niche sports magazine from his home.  Trained as an architect at the University of Toronto, Nick went on to work (for only a couple of miserable years) as an municipal architect with the city before dedicating himself full-time to sports. One of Nick’s most memorable ...

Administrative Bloat in Healthcare is a Land of Opportunity: On Direct to Consumer Price Transparency

I was recently connect with two smart entrepreneurs (James Millaway and Stan Schwartz, MD) who run a company called The Zero Card.  Their business is a platform where consumers and employers have access to transparent “cash” prices for a range of medical services.  Providers display their best non-insurance rates and offer a fixed price for an episode of care. Individuals (or ideally self-insured ...

Can “Agile Teams” Reform Healthcare Systems?

I recently had lunch with an experienced physician executive from a large academic medical center.  He told me that his organization was trying to migrate from fee-for-service to risk, and that management had appointed a bunch of large committees to oversee everything from a new cost accounting system to the development of multiple external partnerships.  

The Pendulum Swings Between Individualism vs. Collectivism in US Healthcare. What Does the Next Decade Hold?

Communities don’t think, don’t believe, don’t want, don’t have needs, don’t have interests and don’t make decisions. Only individuals have minds that generate desires and needs – and only individuals can make choices and decisions. Harry Browne- Libertarian Candidate for American President, 1996 and 2000 When I visit my European in-laws, some who work in ...

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Segmenting Healthcare into “Luxury” and “Value” Brands… Thoughts On Not Getting Stuck in the Middle.

A few months ago, I wrote about how healthcare is poised to segment according to cost and service levels– and that we will likely begin to see healthcare brands emerge that appeal to price-conscious consumers looking for reliable, basic care. My suspicion was that US healthcare is now facing its “Southwest Airlines” moment, where nimble and lean competitors will soon undercut inefficient legacy ...