The January 31, 2011 New York Times has an interesting article, "Concierge Medical Care With a Smaller Price Tag".
What's especially interesting is that the profiled One Medical Group practice offers reasonably-priced high-quality care which takes into account the whole patient. In other words, it is the "integrated care" that government programs like "medical homes" and "Accountable Care Organizations" are striving for. But in this case, it is achieved by physicians adopting innovative practice models in a private setting -- not via government mandate.
The innovations that One Medical Group are making are possible only because the government does not dictate to them what sort of "practice guidelines" they must adhere to, how they must document their care, etc. Instead, the physicians are left free to follow their best rational judgment to provide the best care for their patients. Such innovations can and should be the norm in a private health care economy, where multiple groups could arise and compete for patient business.
Under the coming government-imposed models of giant ACOs and "medical homes", small and nimble private innovators such as One Medical Group will become increasingly hard to find -- or may be driven out of business altogether. In many ways, it will be analogous to the Eastern bloc countries forcibly replacing small private farms with the large inefficient state-run "collective farms".
Those socialist collective farms were an abject failure and couldn't feed the population of the USSR.
There's no reason to think that state-run medical ACOs will serve the health needs of Americans any better.
The blog of Freedom and Individual Rights in Medicine (FIRM)
