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Another Voice: Health consumers facing a Rubik's Cube of change

By John Bartimole

The headlines scream healthcare confusion:

“CVS/Aetna merge in healthcare megadeal”

“Amazon teams with Berkshire Hathaway and JP Morgan to address healthcare woes”

“Future of Obamacare uncertain”

“Apple plans health clinics for its employees”

Add it all together, and it’s more twisted than an IV line around a pirouetting figure skater.

So, what does it all mean to the consumer? What impact will it have on us as we go to our doctors, visit our hospitals, pick up prescriptions from our pharmacies? Good or bad? Blessing or curse?

Unfortunately, no one really knows how these events – as seismic as they may seem – affect our everyday health care lives. But we can take a guess.

First, Obamacare. The reality is that right now, other than the individual mandate being repealed, not too much has changed in Obamacare. As long as consumers are watchful of their policies, there should be little, if any change. But, since the Trump administration diminished the amount for marketing and advertising Obamacare, it is imperative that consumers are aware of deadlines to renew or change insurances.

The Amazon effort will also have little impact on everyday health care, except for the million or so employees of the three companies. However, we believe that this union is a laboratory for effecting permanent change in health care delivery. Employers and insurance companies will be watching carefully to see how this experiment works. Amazon rarely fails at what it does, and the other two business behemoths do not spend money unwisely. If their experiment works, others will follow. Unfortunately, I am not quite sure of the specifics of that experiment, so we’ll have to wait and see.

Apple’s venture is promising, in the sense that it seeks to provide accessible health care to its employees. As any physician will tell you, it is typically much easier to treat an illness in its early stages, rather than when it blossoms. While this is not Apple’s first venture into health care — its health care apps are very popular – this may be the one that may be most replicable by other employers across the country.

Most worrisome, however, is the CVS development in the sense that it may – repeat, may – have the effect of steering consumers to its own pharmacies by subtly (or not so subtly) encouraging Aetna policyholders to favor CVS pharmacies, perhaps curtailing consumer choice. Of particular concern would be the fate of independent pharmacies, those community pharmacies that have been in neighborhoods for generations. Lacking the sheer numbers and influence a pharmacy chain can wield, community pharmacies are too-easy prey for those who would wish to limit – or strongly discourage – from doing business with these independent, long-standing pharmacies.

Strong emphasis has been made recently by state and local governments and agencies on preserving consumer choice, and it’s important that as level a playing field as possible exists in health care.

Add all of these developments up – and undoubtedly, with more to come – and it’s as confusing as a Rubik’s Cube ... and perhaps just as difficult to figure out.

John Bartimole is a health care consultant.

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