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May 3, 2005
I spoke to a store-owner today. He sells over the counter medicines,
magazines, cards and other assorted small items. He used to have a
pharmacy in his store but closed it. In its place is an Internet Café which
he claims is doing very well. When I told him I thought the pharmacy
would be more profitable he said that insurance companies are slowly
eliminating any profit margin that pharmacies used to enjoy. In some
cases he was actually LOSING money on drugs he had to purchase for
his customers. Sound familiar?
Progress so far has been slow trying to recruit employers in northeast
Ohio to join the PAG Alliance. Conceptually the idea of employers and
physicians coming together to determine usual and customary charges
for services is appealing. However, companies want numbers. They want
to know how much of the provider buffer, which they seem to think is
in the range of 33%, can be whittled down to save money when they purchase
physician services for their employees. PAG is trying to convince them
that providers should receive greater not lesser reimbursement for
their services, and that the increased pay to providers should come
from savings obtained by restricting the scope of services that insurance
companies provide.
The PAG Alliance is interested in cash pay for low end healthcare.
A list of charges for services should be made available to patients
to encourage development of a new and open competitive marketplace.
Serious medical problems including surgery still need to be covered
by health insurance. Perhaps a non-profit healthcare insurance company
owned by employers could cover high end costs and save employers money.
The company could be governed by an alliance of employers and physicians.
Similar alliances could be developed between employers and hospitals,
employers and pharmacies, etc.
Employers agree that more responsibility needs to be placed on employees,
that they should spend healthcare dollars in a way that makes them
limit the amount of services they think they need. They agree that
Health Savings Accounts (HSA’s) are a step in the right direction
but are much too restricted at this point in time. They agree that
insurance companies have way too much control over the mindset and
purchasing power of employers and employees and over the reimbursement
of physicians. Eliminate the middlemen.
We need a spark on the employer side. Parker Hannifin Corp. suggested
presenting the PAG Alliance concept to the Health
Action Council comprised of 50+ northeast Ohio employers. PAG is not
quite ready for this. We are meeting with representatives of
Jo-ann Stores, Inc. on Wednesday May 11th. We continue
to meet with other Employers in hopes of finding
an advocate on the employer side who can help provide numbers. Employers
want to see the real dollar benefit in eliminating insurance companies,
trial lawyers, and other cottage industries from the doctor-patient
relationship. |
