Ben Kepes is a Canterbury-based entrepreneur and professional board member. The last thing he wants is for our healthcare system to follow the path of the United States.
Opinion: I recently wrote an article about buying now and paying for space later. For those who haven’t read it, BNPL is a modern (ish) take on the laybye we all used when our kids did far worse things.
As I wrote in my article, the BNPL space has seen significant growth in recent months amid soaring default rates, stagnant customer acquisition and the winds of a tougher regulatory regime blowing in the general direction of these disruptors. I have experienced confusion.
The tone of my article was that the BNPL debacle (or at least the new debacle) is an example of what happens when the tech ecosystem gets confused about how innovative it is. To disrupt much of the economy, technology sometimes raises awareness of its own importance and influence.
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This is certainly true in many sectors, and examples such as WeWork and Theranos illustrate this aspect well. Still, there are times when the tech sector truly deserves the disruptor moniker. An example of how technology and its vendors are about to change entire sectors forever.
One of these sectors is the healthcare sector, which is itself declining in a perfect storm of rising costs, rising customer demand and a huge workforce crisis.
As we have seen in New Zealand over the last few months, we are faced with overworked clinicians, patients receiving suboptimal care, tired infrastructure, a never-ending list of new (and expensive) treatments, and We are witnessing a growing shortage of staff trained to do it all.
Health Minister Andrew Little talks to staff health reporter Rachel Thomas about pressures on the healthcare system, nurse salaries and how the country is trying to solve labor shortages.
For New Zealand, the approach to solving this problem was to completely reform the structure of the health care system.
Countless words have been written about the current reforms, which have their roots in the belief that the overall structure of the system determines its success. We determined that this would improve patient outcomes, equity and economics.
Thinking about the last of these themes, the economy, it’s worth looking at other recent developments, especially news from the United States. Well, the first thing I must say is that the US healthcare system is not what I am looking for salvation.
Health care costs in the United States are among the highest in the world, rising from $2,968 (NZD $4,748) in 1980 to $12,531 in 2020. This spending has created an industry that accounts for nearly 15% of the country’s workforce and one-fifth of GDP.
Long waits, duplication and poor information sharing are rampant in our healthcare system. (Document photo)
All that spending paid off in relative terms. Inefficiency, exorbitant pricing, a hierarchy system where those who can’t afford health insurance die because they can’t get treatment. An economy where two-thirds of bankruptcies are due to health problems.
So no, I’m not going to keep the U.S. as the leader in healthcare delivery. And while I am fully aware that rampant capitalism causes problems (indeed, rampant capitalism causes so many problems), it answers a pressing need. It cannot be denied that there is something.
It is in this light that I was intrigued when I read a few weeks ago that online giant Amazon had announced plans to acquire One Medical. One Medical provides primary health care but uses an online model. The idea, called telemedicine within the sector, is that medical assistance can be obtained via smartphone applications. Tap a button to describe your situation and connect with a clinician online for advice.
Amazon has announced plans to acquire One Medical, an online model for primary care.
One Medical has nearly 750,000 members in the United States. That’s a big number, but it’s a clear inflection point given that Amazon is a member of the Prime service, which covers more than half of all US households. Suddenly, Amazon can offer virtual health services through Prime memberships, and even connect its nationwide logistics and fulfillment infrastructure to deliver medicines to the same members. Speed and convenience, scale and efficiency.
Now I understand your concerns. In fact, these big corporate healthcare providers have an equity issue with what happens to people who can’t afford to serve them.
What about continuity of care? My father was a family doctor. I have parents who he cares for, gave birth (when his GP still practiced obstetrics), and friends who have had a clinician/patient relationship with him over the decades. Will these one-to-one relationships collapse under this new digital model?
Perhaps most of all, for those of us who take great pride in our state-funded health system, are these types of companies siphoning profits by driving down costs and thus lower service levels? And what about privacy?? Can we trust these private organizations to the extent that we can (hopefully) trust public organizations?
All valid questions and I’m not advocating privatization outright here. What I mean is, for whatever reason, we accept a much lower level of overall service from the health department than we put up with from restaurants and hotels.
For some reason, even though health is a big percentage of GDP, the user experience is kind of the worst, to use terms that the tech world has been throwing around a lot. All information sharing is taken for granted by the medical sector for no apparent reason.
And all of these poor user experiences seem to make care nurses, doctors, and hotel managers all frustrated by inefficiencies and lack of innovation.
And that’s the nut we need to crack. Amazon does it differently. The company’s Amazon Care product is an in-house program offered to staff by the tech giant. It also includes telemedicine services and nurse visits to staff’s homes. And Amazon is rolling it out as a product to offer its own customers. We have a deep understanding of how to increase scale, capital and efficiency to deliver better.
That is our challenge here in New Zealand. How do you preserve all the goodness of public health systems while ensuring a world-class user experience? We encourage you to do so by creating a culture of innovation and involving commercial thinking in your system. It is a big challenge, but it must be overcome.
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