Nine Tails Wagging Health Care

I have recently reviewed a book titled THE NEW HEALTH AGE: THE FUTURE OF HEALTH CARE IN AMERICA.  As a convert to integrative health care I believed I had escaped the traps of the modern medical establishment, but now, at 73, still alive and kicking in an election year, I worry. Will the predicted elements of “reform” described in this book come to pass in my lifetime?

The authors, David Houle and Jonathan Fleece are  a “CEOs futurist” and “leading health care attorney,” respectively. Houle is known for his conception of “The Shift Age” (Get used to it: everything is changing rapidly.). Fleece (who should have changed his name) “specializes in advising clients on how to take advantage of health care reform.” Silly me. I thought he meant clients-as-patients.

As soon as I got the book I saw that it has no index. Bad sign. It has a long table of contents instead. If you are interested in the nine “directional flows” you can skip to the chapter on the structure of health care. Concentrate on what the authors have planned for the economics, and particularly insurance, and the “accountable care organizations” (ACOs) that you may be reading about elsewhere. They excuse themselves from talking about the indigent, and point to a solution to cost in stratification of employees by health ratings, and assigning appropriate care according to need. They suggest that the corporations adopt health goals. Then they point to the website of a model “employer accountable care organization” (EACO), Virgin Healthmiles. On this site a CFO (client?) can calculate by entering number of employees and average salary how much money he or she will save the company by these tactics.

No doubt in my mind that this book is written to engage doctors in the reform game. It promises to let them be in control of the “medical homes,” groups of patients to whom they pitch preventative measures, and not just fix the problems after they occur. They give us the math! Doctors can lecture in an auditorium to 100 patients, who pay $20 a ticket, about how to avoid dying of heart disease. In an hour they make $2000 instead of the measly $400 they would get for staying in their offices to consult with four patients for 15 minutes each for $100 a pop.

There is one part of the book I really liked: the history of modern medicine, chapters 2 and 3. Things started getting complicated 150 years ago when the “elite” of this nation demanded “the best” of everything, including doctors. From 1847 we got a gradual refinement of qualifications. We can see where that had led us, right back to seeing a no-nonsense nurse when we are in trouble.


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