Here (subscription required) is a fascinating story of successful efforts to control the high health care costs fostered by government price controls, mandates and tax subsidies for third party payments. With this innovation doctors do not get punished financially for spending more time with patients; and they spend no time doing government required paperwork. The only problem: You have to be large to bring health care in house. Some excerpts from the article:
“Last year Quad/Graphics, one of the nation’s biggest printing companies, spent about $6,000 per employee on medical costs, 30% less than the average company in its home state of Wisconsin. Its 12,000 workers spend fewer days in the hospital and take their medicines more regularly.
Even more unusual: Quad provides most of the care itself. Starting with a small plant clinic in 1990, Quad has brought nearly all of its primary health care in-house. As the whir of its giant presses hums through the waiting-room wall, company doctors and nurses practice everything from pediatrics to gynecology.”
“Quad is fast becoming a model for companies desperate to control double-digit rises in health-care costs. Dozens of companies have toured Quad’s clinics looking for inspiration. Those weighing plans to build their own in-house clinics include Toyota Motor Corp.’s North American manufacturing division, Kohler Inc. and Miller Brewing Co.”
“Some Quad doctors say they were initially skeptical about working in a corporate clinic. “When I interviewed, I said ‘I don’t want to just take care of sore throats,’ ” says Ann Merkow, an internist who left the general medical practice she took over from her father to join Quad nine years ago.
But she says she found it rewarding to work with incentives built around patient health. At her own practice, she says, 80% of patients were on Medicare, where doctors are reimbursed per visit but don’t get paid for preventive care. ‘In the other model, you almost get punished for taking time for patients,” she says, “There were many years I made less than teachers in the area.'”