Tuesday, March 4, 2014

What’s Going On Out There

The Moving Finger writes, and, having
Moves on; neither Piety nor
Shall lure it back to cancel half a
Nor shall your Tears wash out the World
                                                          of it.

Omar Kyayjam (died 1133)

In the last month,  my blog’s readership has tripled, and I have been trying to figure out why.

I think, and I am not sure,  it’s because my readers are mostly physicians. I’ve been writing about the flight from the realities of ObamaCare by physicians and patients.

ObamaCare-Induced Realities

 The realities are that ObamaCare-induced premiums and deductibles are rising,  access to care of the middle class to health plans is falling,  young people and the uninsured are growing restless. With the help  and enabling of new IT technologies,  there’s a tangible  return to traditional one-on-one personal relationships between patients and doctors. And    people are becoming  leery of big government as a solution to our health care woes. 

There’s a renewed interest in bottom-up entrepreneurship outside of government as the way to go.

I’m reminded of the early 1980’s when the U.S. was thought to be in irreversible decline,   Entrepreneurs stepped into the gap,  small business start-ups exploded,  young innovators created giant software companies,  and buoyant economic growth followed throughout the eighties. 

“Animal Spirits”

John Maynard Keynes (1883-1946), in his 1936 book The General Theory of Employment, Interest, and Money,  described entrepreneurs as “animal spirits.”   Their  instincts, emotions, and proclivities are to do something positive, something spontaneous, something imaginative,and something intensely personal outside of government  to change and  to reverse the course of human events. 
We see these “animal spirits” at work in the building of the Keystone pipeline,     the explosive growth of fracking-related  industries, the vibrant start-ups in Silicon Valley such as Facebook and Twitter,  and the rise of physician entrepreneurs as an alternative to ObamaCare and the government overhaul of the health care industry.

Emergence of New Business Models

We see the emergence of new business models to counteract rising health costs, stifling bureaucracies, and increasing dehumanization of health care relationships.   One of these models is the so-called direct care primary care model,  which is free of the bureaucratic 3rd party management , byzantine  ICD-coding systems,  and in which minor procedures and equipment, such as EKGs, are free and wholesale-priced generic drugs are dispensed.   

Spontaneous-Seeking of Alternatives

People are spontaneously seeking alternatives to high-priced physician services in hospitals and more personal relationships with physicians.    In academic policy-making circles,  this return to simpler, cheaper, more convenient care is known as “disruptive innovation.”   Whether it will result in the “creative destruction” of some of the existing health care policies and organizational structures  is anybody’s bet.  Regardless of where your bets are,  it’s a compelling story. My  readers appear to be following with intense interest.

Tweet:  Health consumers and physicians are actively seeking simpler, less expensive, and more convenient alternatives to ObamaCare.

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