As healthcare is moving towards rewarding value not volume, follow evidence -based Medicine,measure outcome and coming down to one thing which is providing quality healthcare at low cost.
The dynamic changes in the economy and political landscapes is enforcing new reality in every aspect of life including healthcare. Financial decisions have become more important than clinical decision making. If you believe that more than 60 hospitals have closed in America since 2010 and another 673 rural hospitals are vulnerable to closure across 42 states!
Proposed solution is direct Care , or Concierge Medicine ( mentioned by Presidential Candidate Dr Ben Carson during the debate answering the healthcare question) and recently. As On March second with the support of doctors ( proud to be one of them) and small businesses, The Florida House passed unanimously Direct Primary Care Bill which will cut down the role of insurers and described as ( important step forward in providing quality affordable healthcare. Direct contracting (between the payer and provider without third party) along with Transparency with regards to pricing for different services offered. This will actually save money through proactive care with emphasis on Wellness and Disease Prevention to empower patients. Also empowering physicians to become the financial advisers who deliver the healthcare and control 100% of dollars spent anyway.
Self-funding insurance especially for small, medium sized -Businesses is becoming attractive with direct contracting between physicians and employers which really puts the physicians and patients in control while saving money to employers and patients and improving outcome.
This is the formula for the successful future practice of Medicine. Yes, there is going to be viable options for the struggling middle class American with ever-rising cost of their healthcare. Basically bring it all back full cycle just like the way it used to be direct doctor-patient relationship. Yes, free healthcare market with transparency and quality services at are truly affordable will be the major elements of the overall solution to chronic unsustainable healthcare crisis.