Kickback Philosophy

Opting Out to Opt in for Yourself

August 7, 2013

I’m no enemy of fast food. I just don’t want to eat it. I don’t care if you do. I wouldn’t make it illegal. But some mayors would.

In the socialist worldview, it’s all about top down control. For example, making everyone buy health insurance and then dictating what insurance companies must cover and prohibiting them from screening for preexisting conditions. Or, for example, empowering hospitals to control ACOs and dispensing with the former “logic” of anti-kickback, self-referral and antitrust laws to permit them to herd physicians into the new program.

Some, a few, physicians had already opted out of the government system (Medicare) and out of the insurance system as well, going into “concierge” medicine. They were criticized as somehow being “less than” for not wanting to be a public utility. For not wanting to be sheep.

Although many physicians are rushing into ACO models, hospital employment and other “alignment,” as that system fails, not just economically but in terms of the quality of care and, importantly, the quality of experience, those with the means to do so will opt out. And that presents an opportunity for physicians entrepreneurial enough to establish practices and networks to provide what those patients want.

As the British National Health Service, and many fast food chains, prove, delivering slop is acceptable to many. But others are willing to pay top dollar for quality care and, more importantly, setting aside statistical notions of quality, for high quality wrapped in a high value qualitative experience.

I don’t care how many Whoppers I can get for $5. Do you?

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