At the CRN event, held in Dana Point, CA, JD Kleinke, a medical economist, and Daniel Kraft, MD a physician and tech entrepreneur, laid out how the health care paradigm is changing both from a policy and a technological viewpoint. Kleinke, who spoke first, went into a deep dive on the ACA, referred to it’s critics as “Obamacare.” That term, he said, is purely political and pejorative and sheds little light on how the act has changed the health care landscape, or, in his view, hasn’t.
“The ACA is a violent endorsement of the status quo,” Kleinke said. “It tries to cram 50 million uninsured people back into the existing system.”
The system, Kleinke said, consists of an unholy trinity of providers, patients and payers, or the insurance companies. When authorities first became alarmed at the rapid growth in health care costs in the 1990s, the response was the concept of managed care, Kleinke said. Insurance companies rapidly aggregated into a few huge companies that had the clout to negotiate rates, he said.
Big bullies
“The big companies could more easily bully hospitals and doctors,” he said. “The response was for hospitals to start to band together into bigger systems.” In almost every major market now the same pattern plays out over and over with hospital chains catering to the low, middle and premium ends of the market, Kleinke said.
“Around 2000 the whole game shifted to the supply side,” Kleinke said. Increasingly, the higher costs were foisted upon the insured, the patients. By making patients more responsible for their own health care costs, the thinking went, the market would function to restrict the rise in costs as patients shopped around for the best deal. The trouble with this model was the opaque nature of the market, with various prices negotiated by large insurance companies that made judging a true and fair value for a given medical service all but impossible for the individual health care consumer. And the increasing costs forced many on the margins out of the system altogether.
One way the market has responded, Kleinke said, is to shift more to a retail health care model. Companies like Walgreens, Walmart and CVS are now offering numerous health care options in their stores, including blood pressure, body composition and blood screening tests, all at a fraction of the cost for competing delivery models.
Personalized digital medicine
Ushering along that shift is the rapid development of personalized medical technologies, said Kraft. He laid out the ways in which disruptive digital technologies are being used in concert to drive innovation. One example is Uber, the car ride sharing service. Uber, Kraft said, uses existing technologies in layered fashion — cell phones, GPS, mobile payment systems — to arrive a completely new result. Kraft said the company has now released a new product called UberHEALTH that will make finding health care professionals and scheduling appointments easier. And the new technologies are offering an unprecedented level of transparency on the price of health care services, Kraft said.
But the mobile technologies won’t just bring patients and health care providers together easier and more cheaply; new hardware can actually provide onsite diagnostic services that are simple enough that patents themselves can do them, which potentially could improve the overall quality of care, too. This can be done by uploading smartphone pictures of test blots or strips, or employing new devices — either standalone or adjuncts to smart phones — that can read blood pressure, pulse, blood glucose levels and more.
“All of this connectivity is coined under the term of mobile health or data health. Many consumers are going to have their health diagnostics on their wrist. It will be like a check engine light for your body,” Kraft said.