As I sit in the University of Michigan hospital and watch the amazing delivery of complex care to a diverse group of individuals, its hard to see what's wrong with the system. Then I started reading "Insurance Companies drop Children Only Policies" to avoid the restriction on limiting insurance for preexisting conditions and it hits you in the face....the system is doing what it always does...gaming! "Creaming, Gaming, Dumping" . No matter what you call it, the distortions and hurdles continue to emerge. Take one step forward, you get two steps back. And of course, how do you think profitable organizations work? They are nimble, respond to the new environment, opportunitistic. Its what we love about capitalism as long as we are an investor.
But what about when you are the recipient, not of a behavior driven disease (which we love to hate) but of an out of nowhere cancer at age 8? What then do we think about the creativity of gaming as opposed to using that creativity to try to cover and care for all (or at least more) people.
So right now as I watch clinicians do their thing for complex 90 year olds and tired 8 year olds, I wonder why we are so focused on rolling back health reform . Why are we not studying the "games" and policies of the private sector this year and amending reform to close the loopholes. Why are we not angry that instead of working to meet the goals of the program each organization is in it for themselves. Government planning is not a bad thing.. think roads, schools, zoning, military deployment!
Let the games begin and make sure the gamers know we are watching!
