Ready to Fix the U.S. Healthcare System?

If a man who has made $2 million a day for every day of his life can’t fix the troublesome healthcare system, who can?

Maybe someone who predicted the revolution in healthcare years ago.

An orthopedic surgeon with years of experience observing what was coming over the healthcare horizon, Dr. Alejandro Badia, Co-founder and Chief Medical Officer of OrthoNOW, recognized that the increasing healthcare costs and dysfunction in the system could be solved through the efficiency and cost-effectiveness of the corporate world.

Early on Badia broke with convention and foretold the possibility of saving patients time and money by cutting out the middleman.

And here we are eight years later.

In February 2018, the legendary Warren Buffet, along with powerhouses Amazon and JP Morgan Chase, announced that his next undertaking would be tackling the country’s healthcare mayhem.

“Such a move has been in the making for some time. This is a powerful announcement that packs an emotional punch for patients,” said Badia. “People have been looking for some reprieve, and this very early step from Buffet, Jeff Bezos and Jamie Dimon provides at least a sigh of relief that someone will give this behemoth of a problem their all.”

And yet there is a vacuum — one which means medical business opportunities are a great option.

“Still,” said Badia, “the group has yet to provide any details on their undertaking. Doctors in the trenches know very well healthcare costs are astronomical and unfair, and that things are not improving. And while third-party payers have their own immense expenses, ultimately, the costs are born by the insured and their employers.”

And what costs they are! According to the Centers for Medicare and Medicaid Services (CMS), national health expenditures grew 4.3 percent to $3.3 trillion in 2016, or $10,348 per person, and accounted for 17.9 percent of gross domestic product (GDP).

And with the system throwing curve balls left and right, it’s good to have someone like Badia, who has been ahead of the curve for several years.

“This healthcare environment means there are novel medical business opportunities available for many parties,” said Badia. “At OrthoNOW, for example, we have been able to strip out unnecessary costs by eliminating paperwork and streamlining the process. A patient comes in, is evaluated by an orthopedic expert, has an X-ray onsite and leaves with medication. This contrasts with the ER, where an orthopedic person is typically unavailable, and the patient is ultimately referred to a specialist, who in most instances cannot see the patient for a couple of weeks. In many cases, not getting the correct diagnosis from the beginning ends up complicating the problem and resulting in unnecessary costs.

“The key to the Buffet/Amazon/JP Morgan announcement is that it’s making businesses sit up and pay attention, with the sentiment that it needs to somehow join in this effort. It is hard to ignore this triad, which comes with millions of employees and a market value in the trillions. To date, the Buffet/Amazon/JP Morgan announcement has little meat on the bones. However, the paradigm shift in how much of the marketplace is dictated by insurers has begun,” Badia continued. “This is because ultimately patients and employers pay the premiums, and the so-called consumers may make increasing demands that they get more bang for their buck. Specialized walk-in care centers are great medical business opportunities now and are well positioned to gain in such an environment because they increase the efficiency of that type of care by at least one order of magnitude.”

Some have speculated this could take insurers out of the system.

“We may end up in a system where doctors and patients are dealing with one another more directly and the middleman — the insurer — plays a much smaller role,” said Badia. “The overarching issue with healthcare costs is that no one has performed a thorough assessment of how healthcare is delivered. Also problematic is the fact that we have a system of gatekeepers and generalists making the initial decisions, which is counterproductive because there is so much complexity; it is critical to get the appropriate specialists involved early on. This is not a problem with medical business opportunities like OrthoNOW, as the model provides for the immediate intervention of the provider who is most suited to help a given patient.”

Another possibility? Amazon could be the one selling you that hip implant. An article on hints at the possibility that the company may “… break into both healthcare administration and the distribution of equipment, drugs and devices.”

“If that happens, we may see a complete reshuffling of the day-to-day practice of medicine in this country,” said Badia. It’s difficult to foresee all the possible effects, but one is for sure: the healthcare segment will continue evolving and medical business opportunities will continue to grow while they try to fill in the gaps in the current marketplace.”

I’d bet a month’s premium on that.