The Business of Healthcare

Moving Away From Big . . . Except In Healthcare

September 23, 2013

It’s almost 2 pm and I’m hungry and I’m thinking about going to a restaurant for lunch.

But for the last hour or so, instead of thinking about my stomach, I’ve been thinking about the overall business model of healthcare and how it’s changing.

But is it changing for the best?

In almost every area of society, the change is away from big, away from corporate (or at least traditional corporate), toward small.

All courtesy of the microchip.

So, we have Zip car competing with Hertz and Avis and even, for some, with the notion of owning a car at all.

And, we have AirBnB, linking home-sharers with travelers looking for a place to stay, competing with Hilton and Marriott.

And so on.

Yet in healthcare the model is changing in the other direction, toward big, toward hospital-centricity. This is swimming upstream in the river of data and connectivity that enables health information to be shared across independent providers (which is what HIPAA is all about).

The shift toward hospital-centric healthcare can’t last. It can’t because everything about it runs contrary to society’s direction. The only way this won’t be true is if it’s imposed by force. Oh, I mean by rule of law.

There are some cracks in the system already. Walk in clinics of various stripes. Physician services as cosmetics. Travel medicine. Concierge medicine.

But those ideas are not truly disruptive in the sense of the anxiety that say, Uber is giving to the taxi business.

Why not doctors freely using facilities like performers access concert venues? Why not links among providers like “code sharing” among airlines? Why not individuals sharing healthcare cost risk via crowd-sourced risk pools without exchanges or employers? Why not a star system of healthcare providers? Why not boutique hospitals within hotels? Why not offshore health destinations unregulated by national governments?

Well, I’m still hungry but I don’t think I’ll go to a restaurant. There’s a food truck that just pulled to the curb down the block. The restaurants may not like it, but I do.

(So why not mobile hospitals or physicians offices rolling down the street?)

What’s your idea?

Let me know.

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