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McCain v. Obama It's Healthcare Stupid

Healthcare Development & Architecture

Author’s Note:  Everyone’s asking [everyone in my little corner of the world, that is]:  Healthcare and the upcoming election is a HOT Button Issue!  It’s a HOT Button for many Americans.  And, without a doubt, it’s a HOT Button for members of the Medical Tourism Association – those invested in the dream of a competitive, worldwide system.   What’s going to happen come November 5th?  What if it’s Obama, or McCain?  What if we stick our necks out in this article and speculate a bit about November?  WARNING:  Henry Ford said:  “Speculation is only a word covering the making of money out of the manipulation of prices, instead of supplying goods and services.”

“Healthcare is in the midst of a ferocious war; the prize unimaginably huge:  $2 Trillion Dollars – the size of the economy of China.  Four armies are battling to gain control:  Insurers, Hospitals, Government and Doctors.  Yet you and I, the people who use the healthcare system and pay for it all, are not even combatants.  And the Doctors, the group whose interests are most closely aligned with our welfare, are losing the war.”

Things change quickly in election years:  Partners; Positions; Platforms; Personalities.  When Power’s in play, everything’s up for grabs.

Every four years, there are more waffles and ‘wafflers in Washington DC than on the menu at IHOP.   Incumbents, Challengers, Dark Horses and Light all blow with the wind ~ and blow out about anything that will fool the people, all the time.

One thing won’t change this November:  Healthcare is a top issue.  Cost, Quality, Access to Care have been Top of Mind for the last 5 elections.   Surprise! 2008’s no different.  And what the candidates choose to say on the subject is, as always, a moving target.

For 25 years, we’ve deliberated, discussed, debated delivery but guess what?  It’s déjà vu all over again.  Johnny and Barry have healthcare on their teleprompters, in their talking points and on their menu at the Waffle House.

What have they been doing for 25 years?   It doesn’t matter now.  What matters for members of the Medical Tourism Association is: “What will this new batch of reformers and idealists bring to healthcare, and what does it mean to me?”

(Other questions for Medical Globalists might be:  Can I influence the process? How much am I willing to invest in time and mother’s milk to influence it?  There are a bunch of other questions, but money and influence are two biggies.)

It’s safe to say Medical Tourism/Global Healthcare is not on the menu at the Waffle House.  Obama and McCain are focused on domestic care; their proposals/reforms are focused on fixing the internal system.

This ought to be great news to anyone affiliated with Medical Tourism.  From Promoters, to Providers, to Patients, “happy days are here again,” if Democrats and Republicans are ‘fixin to fix U.S. healthcare.  Chances are, nothing will happen and, as always, The Market will decide.

The Market is the driver of Medical Tourism.  If The Market is left alone, Medical Tourism will happen, as it is now.  Unfortunately, government is always threatening The Market with the full weight of The Bureaucracy.  There’s no telling what the unintended consequences will be once legislation is put on the plate.

Before we go speculating on what’s ahead, let’s figure out what’s on the menu as we see it as of this date.  Without any of the gory details, this is the how I boil down each chef’s offering du jour.

On Obama’s Menu.

Do we continue down the same path of reform, and build on an employer-based system where employers provide many of us with benefits, and employers continue to pay most of the cost, no matter how expensive?  The most I can tell, Obama says, “Hell No!”  It’s safe to say Obama’s Healthcare Special of the Day will be something way off the current menu.

McCain’s Menu.

Change the system from employer-based to individual-based, with a structure and incentives that enable individuals to build their own healthcare security without an employer or a big government body butting in.  It’s safe to say his Special of the Day will be off the menu, too.

In a nutshell, that’s where they stand today.  Until the wind blows, they’re ‘stickin to it.  Clearly, these are widely-divergent theories.  Obama’s goal is “universal” healthcare; his tactic is HillaryCare II – a government takeover in exchange for the promise of cheaper, assessable healthcare for all.  (Actually, Hillary’s takeover had government in cahoots with some Insurance Carriers and Hospital Systems.)

McCain, essentially, has us fighting for ourselves in the war over healthcare.

Harvard Professor of Business Administration, Regina Herzlinger, is a healthcare analyst.  Her book, “Who Killed Health Care” illustrates the battle between individual and government control:

“Healthcare is in the midst of a ferocious war; the prize unimaginably huge:  $2 Trillion Dollars – the size of the economy of China.  Four armies are battling to gain control:  Insurers, Hospitals, Government and Doctors.  Yet you and I, the people who use the healthcare system and pay for it all, are not even combatants.  And the Doctors, the group whose interests are most closely aligned with our welfare, are losing the war.”

“The American People must win this battle,” she writes.  “A system controlled by the insurance companies or hospitals or government will kill us financially and medically – it will ruin our economy, deny us the services we need, and undermine the important genomic research that can fundamentally improve the practice of medicine and control its costs.  The current system is well on its way to doing all of these terrible things right now.”

AARP illustrated some of these terrible things in its August ’08 issue:  50% of all surgeries, tests, procedures are not backed by scientific evidence (Huh!?);  Americans spend $500 Billion annually on unnecessary care (What!?);  30,000 Medicare recipients die each year as a result of unneeded care (You’ve got to be kidding me?!); insurance companies add a $360 billion dollars to The Terrible Things List each year (that’s really “servicing” the customers!!).

What does all this terrible stuff mean for Medical Tourism?

Last month, Nicolet National Bank of Green Bay, Wisconsin, asked 500 CEOs and Business Owners a variety of questions about which candidate would better handle issues of the day:  72% said McCain would handle healthcare better…

Jeff Gahnz, former executive with one of the largest healthcare systems in the U.S., is Vice President of Nicolet National Bank.  He said, “If the system remains private, I think CEOs will increasingly look toward medical tourism as an option.  I believe it will certainly be part of the next discussion with their broker.  If an international hospital can truly prove quality, efficiency and price arguments, why not look at it?”

Back in 2006, Nicolet Bank asked those same 500 CEOs about Medical Tourism:  52% never heard of it, but 48% had (to varying degrees) with 9% being, “Very Familiar.”

Nicolet then asked:  How interested would you be in traveling to another country for a routine procedure if you knew the cost would be considerably less – and the care equally good?

“A third were interested,” said Dr. David Wegge, president of IntellectualMarketing, LLC – the firm conducting studies for Nicolet Bank.  “I don’t know how this compares to national data; I suspect we’re the first to ask.”

Wegge was surprised the number was that big, “especially among CEOs who probably have insurance and fewer financial worries.”  (30% were: “Definitely Not Interested” 23% were, “Probably Not Interested” and 19% said, “It depends on the Country.” )

Nicolet also asked 1.) “Would you be more interested if a medical trip were combined with a business opportunity; 2.)  Would you be more interested if it included a vacation with spouse/partner.  “The levels changed substantially,” he said.

Wegge is also the Chairman of the St Norbert College Political Science Department.  He added, “No matter who wins in November, it is unlikely that there will be any significant change in healthcare.  Political forces are extraordinarily strong to maintain status quo. However, if McCain is elected, it is more likely Medical Tourism will expand at a faster rate; if it’s Obama, there’s some possibility that Medical Tourism will be less of a force because his plan focuses on covering the uninsured – likely to shrink the Medical Tourism market.”

OK, MedTourism proponents should vote McCain, right?  (Those who don’t vote or can’t because they aren’t citizens are still able to participate in our “participatory democracy.”  Your money’s always welcome!)

On the other hand, HillaryCare II – the government system Obama is leaning toward, might drive people to The Global Marketplace faster than the first plane leaving Ronald Reagan Airport on a Thursday afternoon when Congress is in session!  If my government is going to take over my healthcare (on top of my Defense, my Homeland Security, my Post Office, my Education, etc.,), then I really don’t want them touching me where it really counts!  I’d much rather be in the private hands of a private hospital on a private beach in Costa Rica for crying out loud!

Sandy Mathy is President of, Inc.  She’s been designing innovative, incentive-laden, individualistic health plans for self-insured clients for 30 years.  Former Vice President of Marketing at American Medical Security Insurance Company, she headed the company’s charge against Hillary’s coup in ‘93.  Today, Sandy says it doesn’t matter who wins if you’re a MedTourism proponent.

Nevertheless, she keeps one eye on Washington – just to be safe – but her primary focus remains, The Market.  She’s currently rolling a plan around in her head where the in-network benefit is actually, “their’s out there,” she said.  (“Their’s” meaning:  People in Medical Tourism [that’s YOU, Dear Reader!].)  “Insurance companies just have to get the incentives right.”

Wendy Arnone, President of insurance giant UnitedHealthcare/WI said, “The medical travel phenomenon is more or less in its infancy,” she said.  “UnitedHealth Group serves a large number of Fortune 500 companies – many of which are global – and we believe we have an obligation to explore this trend, both to serve the potential needs of our clients, as well as to address the needs of the un-and-under insured.”

Score another for Medical Tourism!  When The Big Boys like UHC…I should say:  When The Big Girls like UHC take interest, you know something big is happening!

“Health and well being companies that are able to coordinate care across international care provider networks and use similar data standards will be best positioned to support consumers who elect to receive medical care overseas,” Wendy said.  “Successfully supporting medical travel requires more than simply purchasing the consumer’s airline ticket and identifying an overseas hospital where the procedure can be performed.  The same attention to accessing quality care and coordinating treatments among multiple care providers that we have come to expect in the U.S. needs to be applied to medical travel as well.”

QUESTION:  If everyone is in such a tizzy about this election, why are SO many insurance executives, brokers, consultants and providers going to San Francisco for the FIRST, Medical Tourism/Global Health Congress?  Why re-invent the wheel if the wheel is going to fall off?

ANSWER:  It’s not about the election.  The Tipping Point is past/The Market is here.  Then only thing missing is speculation by pundits and profiteers…then, threats of government interference and/or regulation.  For now, The Good News is:  Politicians have bigger fish to fry than citizens flying off to Costa Rica for elective Colonoscopies. To illustrate that point, the only politician on the dais in ‘Frisco is Wisconsin Assemblyman Frank Lasee.  (He’s one of the GOOD ones.)

Until a bill from the Waffle House is on your table, it’s too early to get indigestion over what we might have to eat in November.  So, go to San Francisco; drink some wine; network like crazy; develop relationships and wait for your ship to come in (or go out to Costa Rica).

Michael Bina is a regular columnist for this magazine, as well as a one-time, two-bit politician who ran – unsuccessfully – for office in the Wisconsin Assembly.  He learned all about Politics and its changing Positions, Partners and Platforms, but his education was too little, too late to win.  Early on, however, he did develop a taste for Mother’s Milk – which became his beverage of choice to this day!  Today, he’s out of the public spotlight and back in the bosom of the private sector.  He’s planning to attend the Medical Tourism/Global Health Congress in ‘Frisco in September.  You’ll find him wandering the exhibit hall like a politician looking for votes – dropping business cards in every fishbowl and angling for an invitation to a Happy Hour at a local Mother’s Milk Bar.  E-Mail him if you want a copy of the Nicolet Bank Study:

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