The Future Of Our Health Care System

Bruce Bialosky
Monday, August 30, 2010

Michael D. Tanner of the Cato Institute has just written a pamphlet entitled Bad Medicine. It’s a comprehensive analysis of the Patient Protection and Affordable Care Act (ObamaCare). When you read it, you quickly begin to wonder where the health care system in this country might be headed. One company has already staked out its vision, and just might be establishing the model that all of us will be using in the years ahead.

Les Bider was seeking a new opportunity. He had worked his way up to serving as Chairman and CEO of Warner Chappell, the music publishing end of the record business. The company was sold in 2003, but Bider stayed on through 2005 to run operations for the new owners. After leaving Warner, he kept busy with charitable interests and his family until January, 2008, when he decided he again wanted to do something professionally. But he wanted the right thing because his desire to get involved professionally was more a want than a need.

Within a month, he happened upon PinnacleCare. Bider put his money where his mouth was by investing in the company before he started working with them. Then after some thoughtful analysis and a series of meetings, he decided that he wanted to jump in and became the CEO.

PinnacleCare confronts the complexity of today’s health care system on behalf of its members. The three major aspects of the program that it provides for its members are 1) Simplification of the ever-more-complex health care system, 2) High-level analysis of their personal health, and 3) Notification of the most up-to-date tests and procedures to maintain good health.

The program does this by providing objective third-party advice. They focus on wellness and health care episodic events. If you have a health problem, the company informs you of the best place to get care by analyzing the quality of available health care providers and determining the physician best suited to meet your specific needs. They do what the industry has been missing for years – evaluate the performance of hospitals and doctors. This is where they clearly separate themselves from their competitors, who function more as a referral service without any substantial evaluation.

They start by computerizing your records, and then having a third-party doctor analyze your complete health picture. Depending upon the findings, along with personal factors such as age and family history, tests or procedures are identified that may help maintain or improve your health. In effect, they provide a manager responsible for creating a comprehensive health care program tailored to you.

PinnacleCare then adds a wide-ranging set of services, including travel medical insurance, travel intelligence reports, medical evacuation services (in case you have to get treatment at a critical care center), medical intelligence reports that evaluate doctors, locations of medical centers of excellence and their specialties, along with access to medical advisory boards.

This service does not come cheaply and not all of these services are included in their most basic program. Their basic program for the first year, when the initial analysis is done, costs $5,000 per couple. The second year, the price drops to $2,500. Costs for more comprehensive packages go up from there. Yet they have already enrolled 3,000 members, 90% of whom are American. They have not fully adapted their program to handle changes in the health care system imposed by ObamaCare, but they will make adjustments as they feel it necessary.

Mr. Bider told me that for now, his company would not be going after a larger market by creating a more affordable product. But he does believe that as the company becomes more successful, an entrepreneur will eventually come in and create a similar, but less expensive service. The need for individuals to manage their own health, combined with an ever more complicated health care system and increasingly sophisticated medical procedures, will compel people to do more than just visit their primary care physician for an annual checkup.

The Obama administration wants to take ever greater control over our health care system and create an equality of results for all Americans. As they attempt to dictate our health care options, people will fight back by enlisting companies like PinnacleCare to put them back in charge of their own fate. It has been said many times that “if you don’t have your health, you ain’t got nothing.” Your choice may come down to a faceless bureaucrat or companies like PinnacleCare. Mr. Bider is betting you make the same choice he has made.