Sitting in a regional meeting for Aetna recently gave me time to reflect on bigger thoughts about how to tackle healthcare in the United States. In seeking solutions to the healthcare crisis, politicians have a different focus than insurers. Access is the politician’s biggest concern — how to address the needs of the greatest number of their constituency with the least friction possible. And in politics the squeaky wheel always gets the greatest attention. Unfortunately, this approach only ends up resembling that of The Gang That Couldn’t Shoot Straight since this top-down approach completely misses the concern about affordability. Special interests and sorrowful personal stories trump (no pun intended) cost efficiencies. Ironically, as we witnessed during the ACA debate, politicians look to point fingers and the obvious direction was at the insurance carriers.
Health insurance carriers, in contrast, concern themselves most with cost considerations in order to remain competitive in the marketplace. This bottom-up view uses clinically-based analytics to improve patient experience and reduce costs by employing the latest medical trends and emergent technologies.
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