This is one of Dr. Bricker’s best videos. In 7 minutes he puts the current economic status of healthcare in historical perspective.
FROM A PHYSICIAN
That is a pretty interesting parallel to the past. We certainly are seeing some consolidation, but we’re also seeing some shifting of priorities, and the realignment of industries. Now insurers are competing with hospitals which are trying to buy HCP’s. It’s vertical integration. Pharmacy chains buying health insurers…..what the hell? They try some things to see if they work out, and if they don’t, then they shift directions. Nothing you’re seeing out there in the marketplace is permanent. They’re all looking for the silver bullet.
Anecdotally, the mantra of the big hospital companies has been to buy up surgicenters, and physician practices including Urgent Care Centers. The theory has been the PCP’s in these practices will flow patients into the hospitals, helping to maintain their market share. Both Tenet and HCA have been big buyers, and, additionally, they’re growing their network of clinics organically. A few weeks ago, it was announced that Tenet sold all 87 of their developed and purchased Urgent Care Centers to FastMed for $80 M. That’s less than $1 M/location, which is a fire sale price. So, either Tenet wasn’t getting the patient flow to their hospitals they anticipated, or they finally figured out there were inept at running UCC’s (who could have predicted that???), or both. In any case they found their 5-6 year experiment wasn’t working, and they changed directions. Now, how is it that HCA is continuing along this path? Christus already abandoned UCC’s a few years ago, although they still have a few residual legacy clinics open. Look for their shift in direction sometime soon.
Big corporate honchos are arrogant and stupid. They think that since they have lots of money, have made it up the chain to CEO’s and COO’s, and are in the health care business they can run any health care business. Managing a bunch of unruly physicians is like herding cats. Bean counters can’t figure out how to do it. Physicians resent them b/c they’re not one of their own, b/c COO’s treat them as cogs in the big financial wheel. They’re simply not going to crack that nut over the long term. I’ve seen it over and over. It’s like doing the same thing over and over, and hoping for a different result. It ain’t going to happen.
So, all this consolidation and shifting that Dr. Bricker is talking about is in the process of being tried. I would argue that it’s going to be a messy process b/c healthcare isn’t steel or oil and gas. It’s different. Whether or not it’s tamable remains to be seen. If it’s not, then the government will step in. Then, we’ll have a real mess.
