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Primary care physicians can help battle rising healthcare costs

The single point of failure in healthcare is primary care, which is why there's a mad dash to acquire this valuable — and highly undervalued — resource.

Just as Amazon closed a deal to acquire One Medical, CVS announced its intention to acquire Oak Street Health, and then spent another $8 billion on Signify Health. UnitedHealth Group seemingly buys a different physician group every other month. It's the civilian equivalent of a nuclear arms race — an analogy that I can't help but use after having spent 22 years in the Marine Corps Reserve, the latter part of which was working in civil affairs. 

Please indulge me as I expand further on this comparison to make an important point about healthcare. We spend a lot of time thinking, planning and preparing for how military action will affect the civilian population. After all, no one cares that you took out a terrible regime if you did it by demolishing the only bridge that can supply a town with food. It won't win you any brownie points with the people who you're trying to help.

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A popular military concept involves looking for single points of failure in the economic and social fabrics of society. This can be an offensive strategy as well once you understand it. The war in Ukraine is a great example of what I am talking about — it's been amazing to see Ukraine succeed against a massive opponent; I didn't expect them to hold out. 

How'd they do it? The Russians were relying on what Ukraine identified as a single point of failure: the Kerch Strait Bridge, which was the only railway that connected Russia to the southern front and Crimea. The Russians were using this bridge to supply fuel and supplies to the front lines. Last November, the Ukrainians drove a truck laden with explosives, detonated it in the middle of the bridge and destroyed the railway that ran alongside of it. This was a huge turning point in the war. 

I mention this story to draw a parallel: Primary care physicians are the single point of failure in medical delivery. They are the gatekeeper that connects patients across the country to the rest of the healthcare supply chain. They refer people to hospitals, write scripts and offer advice on whether or not to see a specialist. 

We all know that healthcare in America is so complicated that people generally just try to avoid it until they can't. They rely on physicians to help navigate it. They are the gateway to all of our healthcare decisions.

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But those choices often are predicated upon the cost of services. Consumers of all goods and services always run the risk of overpaying for them, but the difference in healthcare is that there are so many more zeroes involved. If a doctor prescribes branded Gleevec for Leukemia instead of the generic, the patient would be out an additional $10,000. Every. Single. Month. 

The only way to win healthcare is for the good guys to take that bridge. Now, I don't literally mean blow it up; rather, we need to commandeer it for good! It may feel like we are surrounded and hope is running thin. However, the direct primary care movement and the independent surgical centers inspired by the Surgery Center of Oklahoma, combined with the nurse navigation solutions like ModRN Health and AIMM that are exploding in the Industry, should give us all hope. 

I know that at the end of the day doctors, and nurses didn't get into this industry to sell overpriced services and drugs. They were born with a desire to serve and make a difference, and if we give them a way to do that, they will flock to it. This is the role every good adviser and consultant needs to focus on: creating opportunities to employ healthcare professionals in ways they dreamed of when they were kids. 

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Every nurse that I talk to about health insurance and benefits immediately tells me how they wish they could seek employment outside of the insurance and hospital machine and start really helping people without jumping through bureaucratic red tape.

I can relate, because my motivation for joining the Marine Corps at 18 wasn't about fortune and fame, but rather sacrifice and service. I take solace that my childhood motivation will win the day in healthcare and destroy this massive tapeworm that is eating away at the U.S. economy and accounting for more than 18% of gross domestic product.

I would like to introduce my peers to one of my favorite quotes by legendary USMC senior officer "Chesty" Puller to help provide some motivation. During the battle for the Chosen Reservoir in the Korean War, one of his officers came to him at a particularly dire time of the battle and said, "Sir, do you know they've cut us off? We're entirely surrounded." His response: "Those poor bastards, They've got us right where we want 'em. We can shoot in every direction."

Healthcare is a racket. Call in the Marines!

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