The energy supply chain is unique. It is unique in that it can not be well timed, it can not be automated, and it is comprised mainly of people who do things rather than parts.
Because it involves mainly people who do things it is difficult to mathematically identify elements of the chain that can be reengineered to improve the process. The human process is so variable that process improvement opportunities do not reveal themselves to the casual eye.
It is difficult enough to get employees of the same company to reorganIze in such a way as to improve what they are doing much less get employees of multiple companies working in such a way as to improve. Where is the incentive to improve the whole? It is not there. Who gets paid if they work together better? No one. Each party is trying to grab their piece of the pie. The cyclicality of the industry is too great to fuel focus on collaboration improvement. This is the history of the industry. So what are we to do? Where one man sees problems another sees opportunity.
Friday, March 26
Sunday, March 21
Healthcare Reform
This morning I am watching Face The Nation and the topic is healthcare reform. When I think of healthcare reform I think of three primary points of focus: access, quality, and price. This posting is regarding the issue of price.
We have an investment in a telemedicine company. The company provides primary and specialty care medical services. It contracts directly with corporations and uses the telemedicine model so that its doctors can be in several places at once. The standard of care is high, the patients are happy, and the price is right.
In this model, the patients get all the doctor attention they need for a fixed price (paid by their employer) and the doctors are not limited to what tests they can run or plans they can implement. The billing process is extremely simple: one employer, one bill with one line item, no insurance company.
In this model employers are buying healthcare directly. The employers are paying the doctors. Now the employees don't have the freedom of choice they do under conventional plans but for no cost to them (paid by employer 100%) they are not arguing. And by the way, this cost the employers about half what they would otherwise pay via the insurance model.
Here is the other part: in this new model, the doctors make money, the employers make money (via huge savings), and investors make money. The only party not making money is the insurance company. Now certainly insurance companies prevent abuse in billing but it seems to me the complexities created by the insurance companies have run past the benefits of their original charter. So maybe what we are really talking about is "Billing Reform". This would suggest that the problem is not in healthcare practice but rather how the money moves around.
I am certain an insurance executive would have a myriad of counter arguments but it is difficult to argue with the actual results in the field of our own services provider.
Before we involved ourselves in this investment, we spent two years studying a larger version of the company which had been operating for more than ten years. The larger version was the University of Texas' Correctional Managed Care operation which provided all-inclusive health services to the State of Texas prison inmate population. This population was 119,000 patient lives and the daily fee of $8 per inmate per day covered everything. By everything I mean doctors, surgeries, pharmaceuticals, dental, vision, disease management (HIV, diabetes, etc), psychiatric, autopsy, burial....everything. The quality of care exceeded what most insured Americans receive and the operation made money. All on $8 per day and costs have not risen in seven years. The difference here as compared to the conventional model is that the provider is trying to save money and the person trying to save money is trying to provide the best care. This leads me back to the same conclusion because only thing missing was an insurance company.
We have an investment in a telemedicine company. The company provides primary and specialty care medical services. It contracts directly with corporations and uses the telemedicine model so that its doctors can be in several places at once. The standard of care is high, the patients are happy, and the price is right.
In this model, the patients get all the doctor attention they need for a fixed price (paid by their employer) and the doctors are not limited to what tests they can run or plans they can implement. The billing process is extremely simple: one employer, one bill with one line item, no insurance company.
In this model employers are buying healthcare directly. The employers are paying the doctors. Now the employees don't have the freedom of choice they do under conventional plans but for no cost to them (paid by employer 100%) they are not arguing. And by the way, this cost the employers about half what they would otherwise pay via the insurance model.
Here is the other part: in this new model, the doctors make money, the employers make money (via huge savings), and investors make money. The only party not making money is the insurance company. Now certainly insurance companies prevent abuse in billing but it seems to me the complexities created by the insurance companies have run past the benefits of their original charter. So maybe what we are really talking about is "Billing Reform". This would suggest that the problem is not in healthcare practice but rather how the money moves around.
I am certain an insurance executive would have a myriad of counter arguments but it is difficult to argue with the actual results in the field of our own services provider.
Before we involved ourselves in this investment, we spent two years studying a larger version of the company which had been operating for more than ten years. The larger version was the University of Texas' Correctional Managed Care operation which provided all-inclusive health services to the State of Texas prison inmate population. This population was 119,000 patient lives and the daily fee of $8 per inmate per day covered everything. By everything I mean doctors, surgeries, pharmaceuticals, dental, vision, disease management (HIV, diabetes, etc), psychiatric, autopsy, burial....everything. The quality of care exceeded what most insured Americans receive and the operation made money. All on $8 per day and costs have not risen in seven years. The difference here as compared to the conventional model is that the provider is trying to save money and the person trying to save money is trying to provide the best care. This leads me back to the same conclusion because only thing missing was an insurance company.
Subscribe to:
Posts (Atom)
