Square One Consulting - Are Jigsaw Puzzles Obsolete

DEFENSIVE MEDICINE! – THE FUTURE IS NOW! (DRAFT)

“THANK GOD FOR PLAINTIFF LAWYERS ESPECIALLY THOSE THAT PROMOTE CLASS ACTION LAWSUITS! THEY ARE GOING TO SAVE OUR NATION, ITS PEOPLE, AND THE ECONOMY.”

There, I’ve said it and I’m glad I did. Now before my friends start rumors that I’ve “snapped” or “sold out” let me assure you I’ll explain this later in this article.

Our Health Care (HC) system (delivery of medicine) and Heath Care Financing (HCF) system (payment for medicine) are broken. The problems are severe - look at your last premium, the premium increase at renewal, the lack of a competitive insurance market, and the complaints of all involved (providers, employers, insurance executives, patients, tax / premium payers, etc.). No one is happy. We’ve got a serious problem.

In the U.S. we spend twice as much on HC than other industrialized nations, yet our infant mortality rates and life expectancy rates are at the median. Translation – we lead the world in costs but we’re also rans in results – ROI (return on our investment).

Personally, I’m a testimony to what’s right in American Health Care. I’m alive today and pain free because of what’s good (great) in our system. I had four angioplasties from February of 1997 through June of 1998. I had a hip replaced in April of 2002. (Thanks to Dr. Carl Luikart [heart] and Dr. Brent Bankston [hip] – they’re great.)

I’m also a foreshadowing of what’s wrong with our system. I have well over $100,000.00 of medicine between my shoulders and my knees. I’m at the front end of the baby boomers (age 55) and I’ve already been to the big “trough” five times. There’s not enough money to allow my contemporaries the same care that I’ve enjoyed.

The good news for me personally is that I’ve got mine. The bad news for the rest of you is that when you need yours it may not be there for you. More good news is that medical science can keep us alive in spite of our personal fitness, lifestyle, diseases, and age. Some of us will make it to 100 and many to the 80s. The bad news is that with the current cost of care we can’t afford this longevity. What’s happened?

Our system has evolved from a world of Marcus Welby, personal responsibility, the individual as a survivor, mistakes happen, physical labor and activity, balanced diets, insurance for catastrophes only, and an acceptance that we’ll all die.

Today our system is one of organs du jour / specialists, victims, no personal responsibility, lawsuits, OBESITY, poor nutrition, $20.00 co-pays, and a right to all the care we want when we want it. Most believe that if something goes wrong the system can cut it out, provide a pill, and / or technology to fix it. Today our system has perfected delaying death even it we have not yet been effective in extending life quality.

Don’t worry about war, terrorism, or our educational system in tomorrow’s world – IF WE DON’T REFORM OUR HC / HCF SYSTEMS (including Medicaid, Medicare and Social Security) BY THE TIME THE LAST “BOOMER” HITS RETIREMENT AGE THERE WON’T BE ENOUGH DOLLARS TO PAY FOR THESE CONCERNS.

As a practical matter, we’ll be safe because no other country will envy us and no one will want to conquer a POOR, FAT, AND OLD COUNTRY FILLED WITH COUCH POTATO VICTIMS (even though it would be easy). WE MUST CHANGE!

To date all attempts at reforming Health Care and the other problems of our demographics (Social Security, Medicare, and Medicaid) have gone nowhere. Congress talks about the issue, legislators debate it, candidates caress it, consumers complain, Bill / Hillary tried (and to their credit they started a debate that needs to be concluded), special interests lobby, but no one produces results! Change is never easy.

Machiavelli explained the significance of the challenge when he said, “There is no more delicate a matter to take in hand, nor more dangerous to conduct, nor more doubtful to success, than to step up as a leader in the introduction of changes. For he who innovates will have for his enemies all those well off under the existing order of things, and only lukewarm supporters in those who might be better off under the new.”

Winston Churchill explained the risk in failing to meet the challenge: “Take change by the hand before it takes you by the throat.”

Tolstoy wove the thread of humanity into the challenge and the risk: “Everyone thinks about changing the world but no one things about changing themselves.”

Maxine (cartoon character) puts a human face on this discussion when she said, “Change is good as long as I don’t have to do anything different.”

The reality of the future is that each of us (all 280,000,000+ people) must change. Will we do this on our own? ABSOLUTELY NOT! People only change when the pain of the status quo becomes too severe or when the potential reward is too great to ignore. (Gambling opponents sometimes buy a lottery ticket when the Jackpot is $200,000,000.)

Let me close the loop. Here’s where the trial lawyers enter the picture.

We none want to change. We as a society are able to change. Unfortunately as Machiavelli described we as individuals are unwilling to do so. WE NEED MOTIVATION. ENTER THE PLAINTIFF’S BAR - THEY ARE GOOD AT MOTIVATING THE SYSTEM.

THE LAWYERS WITH THEIR CLASS ACTION SUITS HAVE WRUNG MOST OF THE DOLLARS OUT OF THE CIGARETTE COMPANIES AND NOW THEY NEED A NEW SOURCE OF INCOME. THEY ARE MOTIVATED. THERE NEED WILL CREATE OUR MOTIVATION FOR CHANGE.

They are now entering the world of obesity. This is pandemic in this country. By embracing the “victims” of obesity, the lawyers will gain access to the checkbooks of the food, health care, and health care financing industries and the insurance companies that protect them (yes – insurance companies buy insurance). There isn’t a better source of funds – we may quit smoking but we can’t quit eating or using HC.

If you need reinforcement on this prediction consider the fact that McDonalds has been sued over their menu / content of their food. Kraft Foods announced the reevaluation (volume and nutritional content) of their products. A doctor in Ohio recently lost a case because he didn’t work aggressively enough with his obese patient.

You can be sure that lawsuits against employers and their insurance companies for failing to provide obesity management programs will be soon to follow.

Ask most doctors about their number one concern and they’ll say malpractice lawsuits. Malpractice insurance is really an ERRORS AND OMMISSION POLICY. In the past most suits were ERROR driven. In the future most will be OMMISSION DRIVEN.

Business owners / entrepreneurs live scared – they operate without a net. Everyday they put their life savings on the line. Ask them their fears and they may not list class action lawsuits. Mention the possibility of a class action suit and they will be scared.

Here’s the reality. You can’t stop a class action lawsuit. The best you can do is to prepare a defense. Employers and others will suddenly realize their vulnerability to this next wave of lawsuits and begin to aggressively pursue primary and preventive programs, nutritional studies, obesity management and prevention, community wellness, etc. Let’s use this new THREAT as a WAKE UP CALL.

This trend will expand. Insurance companies will discover that they need to team with their policyholders in these efforts because if they don’t their lack of interest will be a bullet in the gun of the lawyers. Politicians and elected officials will become involved because of the dollars and public attention. The system is becoming motivated.

Here’s the good news – never underestimate the U. S. When we are attacked we will respond. We are a resilient people. Business owners / entrepreneurs are the most resilient and the most motivated. Once they understand the rules and risk of tomorrow’s world they’ll adapt and they’ll drive the rest of us to do the same.

Last week I was blessed to see the future. I’ll share the experience:

I attended my annual Board Retreat at the National College of Naturopathic Medicine in Portland. Value-added / cost-effective care and results are provided there. This month California will probably license Naturopathic Doctors (N.D.) leading the way to licensing in the remaining states not recognizing this most valuable resource. Naturopathic Medicine is a patient centered primary care approach that uses natural means to restore and optimize health.

I spoke to P. J. Mills a member of the Board of Directors of Pennington Biomedical Research Center in Baton Rouge (www.pbrc.edu) and was reinforced in the “cutting edge” research being performed there in nutrition and obesity management. Pennington is one of Louisiana’s best contributions to the world.

Dr. Al Libke and Mr. Rich Wooten presented the Cyber Care Plan (www.healthport.net / www.cybercareplan.com). This Internet driven system uses technology to leverage the doctor / patient relationship to assure better (more cost efficient and effective) management of wellness, nutrition and preventive medicine. It’s the future.

I worked with the Louisiana Health Care Group (www.lahealthcaregroup.com) to refine and improve the process, pricing, perpetuation, and potential of care at home versus the less effective / desirable and more costly Institutional Care. The care is better; it is much more patient-centered, and as a society more cost effective and desirable. As we age we’ll want this as individuals and need it as a society.

Finally I met with Tommy Canterbury of Sports Care (www.sportscareusa.com) and Donald Powers, a representative of a regional Chamber to discuss the Sports Care community wellness programs – healthier communities. We talked about capturing population, influencing its health, and measuring outcomes. We talked about the business community doing what they do so well – LEADING!

There is hope – there are tools. We are spending more than enough money on HC in this country to take care of all the needs of all the people ($5,035 per person). We need to spend the money more wisely. We need to return consumer responsibility to the process. We need to shift the focus from sickness and end of life care to wellness, preventive medicine, nutrition, etc. We need to recognize that we are individuals comprised of mind, body, and spirit and all of these elements can impact our health.

I can get consensus that the vast majority of illness in this country originate from stress (hypochondria, mental and nervous disorders, or drug and alcohol addiction, obesity (poor nutrition) and smoking yet our providers are for the most part not trained in these conditions and the system ignores these needs.

The death spiral of our system can be reversed and the health of our country revitalized. I’m enthusiastic. It will change. We’ll be around in the future to worry about other issues – WAR, EDUCATION, TERRORISM, ETC. because we can get HC / HCF in order. THANKS TO MY NEW BEST FRIENDS THE TRIAL LAWYERS!

John Kennedy had a Vision to land a man on the moon and return him to earth. When he expressed this dream the science did not exist to achieve the Mission. Today the science and resources exist to address the Obesity, HC, and HCF problems. The only element missing is LEADERSHIP to capture the vision of a healthy America, a redesigned HC system, and a funding mechanism that better addresses the cost of care. I believe it’s time for the business community and civic leaders to step up to the challenge. It’s your business, your community, your money and the lawyers want all 3.

BACK