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Market Access Strategic Execution Consultant

An Idea Changes Reality

Did you know that the archetype for current insurance plans was founded by the Baptist Church in 1903?

Did you know that during the first half of the 1900s, patients paid on an informal sliding scale in proportion to their income?

Did you know that physician assistants (PAs) became a thing in the late 1960s/early 1970s? There was a perceived shortage of doctors; at the same time, a new labor pool presented itself: combat medics returning from Vietnam needed employment and possessed practical skills. That’s when universities started PA programs.

Did you know that DRGs didn’t exist until the mid-1980s? Medicare implemented it to curb the runaway payments to hospitals.

Did you know that it’s only in the 1980s and 1990s that ambulatory surgery centers (ASCs) became increasingly popular. It was mostly individual doctors and investors that were seeking them out.

Did you know that in the 1990s, doctors commonly complained that they made less per hour than plumbers?

Did you know that it wasn’t until the late 1990s buy-and-bill truly became commonplace? The trend was started by a pharmaceutical company.

Did you know that it’s around 2000 when hospitals began to compensate physicians in proportion to relative value units (RVUs) (instead just a fixed salary) to encourage them to see more patients and bring in more revenue?

Did you know that Medicare Part D was enacted recently in 2006, under a Republican president? The government didn’t offer prescription drug coverage for people >65 until then because medicines were always relatively cheap.

Thanks to Elisabeth Rosenthal’s book, “An American Sickness” for these insights. When you shine a flashlight, both you and I can see better.

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