For years I've worked to demonstrate the value of effective primary care as a critical pathway in fixing health care in the US. At first I was surprised and dismayed to hear from insurance execs that I needed to demonstrate a return-on-investment if they were going to fund this good work. I was demoralized by their requests to document every aspect with randomized control trials and depressed when I was turned aside by savvy medical directors claiming that there was no proof.
Finally I began to suspect that maybe, just maybe, the insurance industry was not negotiating in good faith, that their motivation to remain in total control of the money trumped any study, any data, and ultimately any chance at improvement.
I'm shocked, just shocked (not really) to read the account of an industry insider who says essentially the same thing:
Don't trust the insurance industry's stance on health reform, says Wendell Potter, former corporate communications chief for Cigna.
Companies may support reform in public, but behind the scenes they'll do everything they can to derail policies they don't like, claims Potter, who was for many years a consummate industry insider.
Based on Mr. Potter's confessions and my repeated experience of lip-service support for innovation as well as opportunities to review many medical home demonstration project proposals that lack any meaningful funding for the new work demanded of struggling primary care practices, I have concluded that medical home projects backed by the insurance industry are likely to build Potemkin villages and not the homes we need.
I know it's probably career suicide to call out these deeply entrenched interests with their deep ties to policymakers, but I'm hoping (here's naive me again) that there are more folks like Wendell Potter in these companies and in the halls of Congress who would rather take the high road and do the right thing (and I really do think that there could be many more like him) .
If you're one of them, please remember these things:
- The status quo of health care is broken beyond simple repair and needs fundamental reform
- Supporting effective primary care has been demonstrated in the literature as well as in all other developed countries to lead to improved outcomes, improved experience of care, and to reduce the costs of health care when compared to the US norm
- Front like docs like the IMPs have demonstrated once again their willingness to take the high road and achieve the good results
- We welcome your participation in one of the more exciting innovations in health care delivery in the US
L. Gordon Moore