Episode 024: Are HMOs the Past and Present Too?

Episode 024: Are HMOs the Past and Present Too? A Discussion with Dr. Richard Reece.

Sometimes, the best way to understand your present is to view it through the lens of the past. HMOs (Health Maintenance Organizations) were a product of the 70s and exploded onto the scene in the early 80s. The epicenter with the HMOs was Minneapolis, MN which is where our guest, Dr. Richard Reece happened to practice and he chronicled how the disruption of medicine occurred with HMOs. Specifically, he recounts the 'industrialization' of health care delivery where a cottage business of caring for the sick transformed into the business it is today run by large corporations.

Dr. Reece argues that physicians, hospitals, and administrators were initially completely caught off guard with the emergence of HMOs and the corporatization of medicine. Hospitals quickly got swallowed up by health plans and their administrators were replaced by corporate managers. Physician practices were purchased by health plans and hospital systems. That all occurred in the 1980s, however, it is only nearly 40 years later, that physicians have gotten their feet back under them and started fighting back.

Reece claims that the entrepreneurial strain in physicians is starting to buck the industrialization of medicine with innovation like direct primary care. How this will end he is unsure but he suspects we will end with a two tiered system where government run health care will exist alongside a private pay system.

Richard Reece, MD — Dr. Richard L Reece is a retired pathologist, the author of many books on health care, and former editor of the Minnesota Medicine (the Minnesota Medical Association's Journal).

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show notes

And Who Shall Care for the Sick: 1988 Collection of essays and speeches by Dr. Reece describing the altering world of medical care delivery.

Are We There Yet? The Road to Universal Health Care: This is Dr. Reece's most recent book which highlights the inevitable path to a single payer health care system that might be doomed by consumer choices.

The Road to Hell is Paved with Good Intentions: The Story of Obamacare: Dr. Reece's examination of the introduction of Obamacare (http://medinnovationblog.blogspot.com/Affordable Care Act)

Richard L Reece: Dr. Richard L Reece's active twitter handle where you can follow his musings on medicine.

Medinnovation: Dr. Reece's Blog

Abe Books: A great, affordable place to find used books - especially ones out of print.

Physicians Foundation: This is the organization that conducts the biannual survey of physicians.

Episode 006 Dr. Ken Fisher and our discussion on Electronic Health Records

Episode 011: Dr. Belen Amat in why she is so happy she changed to Direct Primary Care which we reference in the show.

Memorial for Andy Larson: This is the donation link to honor Andy's death with the Grand Rapids Choir of Men and Boys where he blossomed and served as a head chorister.

YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.

Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.

Episode 024: Are HMOs the Past and Present Too? A Discussion with Dr. Richard Reece.

Episode 024