It may be the most contentious issue in healthcare today: Who is going to control the healthcare system of the future?
There are as many opinions as there are various industry interests. But as the medical-care delivery system of the 21st century takes shape, some groups currently influential will have to defer to a more consumer-focused, collaborative health system.
With cost containment dominating the agenda, insurers too often are the arbiters of what is acceptable medical treatment, basing their decisions more on financial than medical considerations. They're among several groups losing favor with the public, including lawyers, government bureaucrats and, to some degree, business coalitions.
These groups have a part to play, but in the final analysis the consumer will determine the value offered by collaborative groups of professionals led by-but not dominated by-physicians. Consumers will have better access to information and the ability to change health plans, if necessary.
That's why it's encouraging to see healthcare associations broadening their membership bases and transforming themselves to reflect the changes taking place in the industry.
The California Association of Hospitals and Health Systems, for example, recently changed its name to the California Healthcare Association, added 53 medical groups to its 500 hospitals and health system members, and included four physicians on its 35-member board. This move, which also involves reducing duplication of services, shows that association leaders are willing to do what they are calling on their members to do: get closer to physicians, cut their overhead and refocus their energy on restructuring efforts. Such streamlining makes them more credible as they push for more flexibility and an increased focus on value in healthcare.
Physician organizations, meanwhile, are taking tentative steps to knock down the walls separating healthcare interests. Last fall, the American Medical Association and the Medical Group Management Association formed a strategic alliance for member education, research and database sharing. Next month they will hold their first joint legislative conference in Washington.
No one group has all the answers to the problems facing healthcare. But providers, working cooperatively, have potential to find solutions-as long as they keep in mind that the patient is the ultimate customer.