How will MedOn (p.p.) operate?

In a nutshell -- with most of the goals outlined in Porter & Olmstead-Teisberg's 2006 book on health care --

http://harvardbusinessonline.hbsp.harvard.edu/b02/en/common/item_detail.jhtml;jsessionid=WMYRKFHW0JUE2AKRGWDR5VQBKE0YIISW?id=7782&_requestid=128898

The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums--not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying--and largely overlooked--causes of the problem and provide a powerful prescription for change. The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services rather than create value for patients. This zero-sum competition takes place at the wrong level--among health plans, networks, and hospitals--rather than where it matters most: in the diagnosis, treatment, and prevention of specific health conditions. Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to a positive-sum competition that will unleash stunning improvements in quality and efficiency.

To paraphrase Warren Buffett -- our goals are value, value, value.

Not buck-passing. Not bureaucracy. Not work-avoidance. Not herky-jerky treatment systems.

If it don't get the patient better -- if it does not create value -- dump it.

MedOn (p.p.) began as a logical response to medical tourism -- why burn all that CO2-producing jet fuel?

The short-coming of medical tourism -- still mired in buck-passing. Who's responsible for what?

MedOn's goal is to create 'caring circles of community." To operationalize systematically, and not with the awful, wasteful, and soul-crushing SNAFUs that plague health care today.

To those who say that the Porter/Olmstead approach is unrealistic and unworkable -- we have read your comments.

Our reply: the beauty of MedOn (pat. pend.) is that, at this point, it is a "clean sheet."

No embedded culture of SNAFUs and FUBARs. And a clear, strong vision -- affordable medical treatment for the working-class, to provide authentic patient value.

So .. to those AMA-types who call MedOn "provocative" --

If providing affordable quality medical-care options for the working-class is "provocative" to you, we wish you well.

We're trying to work with others to make things better for patients.

The Indian Health Service of the USA & us

As the inventor of Medical Onshoring (patent-pending), one of the first questions I get is, "what about the Indian Health Service (IHS)?"

My response: "I welcome them as a partner in trying to make health care worldwide better. We're national -- IHS is local. We should work together, not at cross-purposes."

Plus -- I've already improved conditions for IHS (see following).

MedOn (pat. pend.) began as a logical alternative to "medical tourism" -- why burn all that jet fuel?

Knowing our logical, caring beginnings -- to think MedOn (p.p.) would want to directly compete with IHS is "illogical," as Star Trek's Mr. Spock would say. And wasteful and financially-crippling for everyone involved.

MedOn (p.p.) wants to work with IHS -- not get into a zero-sum game with no winners.

MedOn (p.p.) is national -- IHS is local.

We're different. Really different.

Now .. back to caring for patients ..

------

Did MedOn spur federal action for a new IHS facility?

Well ..

First this on 5/15/08, in the "Minot Daily News" --

CHAPEL HILL, N.C. – An engineer in North Carolina has filed a patent for a new medical-care system that he says would be a good business fit with the Minot area.

C. Alex Chien said Wednesday that Minot has the technology, transportation and environment to host a prototype “medical onshoring” clinic.

Chien, a self-employed engineer, is a former rural economic developer with RochesterTel, former owners of Minot Telephone Co. SRT purchased Minot Telephone Co. in 1994.

Then this on 11/11/08 in the "Minot Daily News"

NEW TOWN, N.D. -- The design plans for a $20 million health-care facility for the Three Affiliated Tribes on the Fort Berthold Reservation are moving forward.

"We're looking at a groundbreaking next spring or early summer, with a completion of 2010," said Jim Foote, project manager for the Three Affiliated Tribes' Elbowoods Memorial Health Facility.

In September, Sen. Byron Dorgan, D-N.D., announced that the U.S. Army Corps of Engineers had awarded a $1.48 million contract to launch the design phase to build the health-care facility on Fort Berthold.

Nice coincidence that a long-delayed IHS project accelerates -- or separate matters? You decide.

"Moral Hazards" while traveling

http://www.economist.com/research/Economics/alphabetic.cfm?letter=M#moralhazard

Moral hazard

One of two main sorts of MARKET FAILURE often associated with the provision of INSURANCE. The other is ADVERSE SELECTION. Moral hazard means that people with insurance may take greater risks than they would do without it because they know they are protected, so the insurer may get more claims than it bargained for. (See also DEPOSIT INSURANCE, LENDER OF LAST RESORT, IMF and WORLD BANK.)

Per the Fannie/Freddie disaster -- when Americans travel overseas in questionable areas -- who bears the cost of saving them? As in this case --

http://www.inthenews.co.uk/news/autocodes/countries/south-korea/taliban-free-more-hostages-$1127908.htm

Taliban insurgents released all remaining South Korean Christian aid workers held in Afghanistan today.

The remaining seven hostages were released in two groups on Thursday, one day after 12 of the hostages held since mid-July were freed.

Agreement had been reached on Monday between the Taliban and South Korean negotiators to end the hostages' ordeal.

South Korea will remove its 200 troops and all missionaries and other civilians from Afghanistan by the end of the year in return for the release.

The 23 South Koreans originally captured were abducted as they travelled from Kandahar to Kabul on July 19th.

Two male hostages were subsequently killed after Taliban gunmen said their demands were not being met, while two female missionaries were later released as a goodwill gesture.

The world is a dangerous place. Obviously.

Medical care -- more than the surgeon's fee

Much has been made about the cost of medical care and "the benefits of medical tourism." Well, to quote an old professor -- "it is a little more complicated than that."

The price/cost? That's getting easier to find. Here's the reported cost of a heart transplant --

http://wiki.answers.com/Q/How_much_does_a_heart_transplant_cost

Is that enough?

Of course not. So many other factors -- pre-surgery, your GP, after-surgery.

Complicated. Not atom-splitting. But not simple, either.

State of the Heart: A Medical Tourist's True Story of Lifesaving Surgery in India

The story that helped kick-start "medical tourism" ..

In 2004, at the age of fifty-three, self-employed contractor Howard Stabb learns that a leaking mitral valve in his heart needs to be repaired. Left untreated, his doctors tell Stabb, his condition may kill him at any moment. The procedure to repair the heart valve costs at least $200,000 at the Durham Regional Hospital near Stabb's North Carolina home-if there are no complications.

This gripping memoir describes Stabb and Grace's experiences from the initial diagnosis through their trek to India, the operation Stabb undergoes, and the chilling dangers he faces after the surgery. In an afterword, the book offers resources for readers considering overseas health care, including hospital recommendations, visa and inoculation information, and things to look for when choosing an overseas health care provider. In all, the memoir alludes to the collective story of the more than 43 million uninsured Americans who face, everyday, the very real possibility that their lack of health insurance may either bankrupt or kill them-if not both.

Medical Tourism & Patient Data

Under "statistics, damn statistics and lies" ..

http://travel.nytimes.com/2006/10/15/business/yourmoney/15care.html?sq=thailand%20hospital&st=nyt&scp=4&pagewanted=print

In Bangkok, Bumrungrad International Hospital counts 55,000 American patients a year.

McKinsey & Company's report on medical tourism, using a very rigorous, very conservative data-approach --

http://www.mckinseyquarterly.com/Mapping_the_market_for_travel_2134?pagenum=1

"Between 60,000 and 85,000 people annually travel abroad for inpatient hospital care, a number .. far lower than commonly assumed."

Probably some of the difference is between elective and acute situations.

Mumbai, India attacks

In a terrorist attack -- not even a hospital is off-limits --

http://en.wikipedia.org/wiki/Cama_Hospital

The 2008 Mumbai attacks were ten coordinated terrorist attacks across Mumbai, India's financial capital and its largest city. The attacks, which began on 26 November 2008 and lasted until 29 November, killed at least 173 people and wounded at least 308. The attacks drew widespread condemnation across the world.

Eight of the attacks occurred in South Mumbai: at Chhatrapati Shivaji Terminus, the Oberoi Trident, the Taj Mahal Palace & Tower, Leopold Cafe, Cama Hospital, the Orthodox Jewish-owned Nariman House, the Metro Cinema, and a lane behind the Times of India building and St. Xavier's College. There was also an explosion at the Mazagaon docks, in Mumbai's port area, and in a taxi at Vile Parle. By the early morning of 28 November, all sites except for the Taj Mahal Palace had been secured by Mumbai Police and security forces. An action by India's National Security Guards on 29 November resulted in the death of the last remaining attackers at the Taj Mahal Palace, ending all fighting in the attacks.