Home > Improving Healthcare > What is the Appropriate Scale for Delivering Health Care?

What is the Appropriate Scale for Delivering Health Care?

In the prior post, I noted the opening of Yale Law School’s new Solomon Center for Health Policy and Law.  At the opening, there will be a conference on “The New Health Care Industry: Integration, Consolidation, Competition in the Wake of the Affordable Care Act.

Of course, the so-called “new health care industry” is anything but new. It has been evolving for years, though Obamacare has certainly accelerated it.  A better title would be “The Continuing Evolution of the Health Care Industry: Consolidation and Extinction.”

Given its title, the conference will likely focus on BigHealth — the consolidation of health systems and insurers.  We are seeing it everyday, and it is certainly important.  Unfortunately, the conference will ignore the real battles in the evolving health care industry and where they are being fought and by whom.

I am in the tenches everyday with solo and small physician group practices and other small health care providers as they try to remain independent and give quality health care services to their patients and get paid a fair price for their expertise.

I doubt that there will be any room for LittleHealth in the future, but maybe there should be.  One size does not fit all.  Who hasn’t experienced the difference between the service provided by Bank of America and that provided by the local community bank?

Nearly 40 years ago, E.F. Schumacher wrote “Small is Beautiful.”  One of the lessons he sought to teach us is that we often overlook what is the most appropriate scale for an activity.

Small may not always work, and sometimes bigger is better.  But I don’t know if anyone has really thought about it where people’s health is concerned.  I would like to see a conference focus on the question of what is the appropriate scale for health care delivery and how to get there.  If there is room for the small health care provider, we better find out before they all go the way of the dinosaurs.

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