I Don't Like His Message But Could He Be Right?

Dr. Ezekeil Emanuel has a new book that is out, "Reinventing American Healthcare."  I am not a big fan of Dr. Emanuel, although I have never met him.  I have seen him on various talk shows and read some his work.  He gives the appearance that he is the smartest man in the room and it doesn't matter what room he is in.  I am not saying that he isn't a bright guy; but maybe listening once in a while may be beneficial.  

For those of you who don't know him, he is a former or current health policy advisor to the Obama White House (no one is really sure) and brother of Rahm Emanuel, former White House Chief of Staff and current Mayor of Chicago.  Ezekeil was rumored to be appointed the CEO of Obamacare when it was first rolled out and was failing miserably.  The White House was testing the waters that it needed a leader to get it fixed.  I am not quite sure what Kathleen Selibus, Secretary of Health and Human Services, and her many deputies, assistants and under secretaries were doing, but the idea was put out there; fortunately, it never got any traction.  

Getting back to the message in Dr. Emanuel's book: do we really need 5000 hospitals across the US?  He says that smaller hospitals are finding it harder and harder to recruit physicians as well as find funding to support things like IT and the the entire patient care infrastructure.  (By the way, WMHS is considered a medium sized health system, whew!)   

The challenge will be that many of these smaller hospitals are the largest employers in their communities and, in many cases, the engines driving their economies.   There is probably some truth to his message.  When U.S. health care was at its peak of $3 TRILLION in annual spending, there was a lot of money to go around.  That is no longer the case.  Health care is being transformed, as has been the case at WMHS for the last three plus years.  But when it is all said and done, every hospital in the U.S. will be making dramatic changes to how they do business, including getting cost out of their hospitals.  Such a requirement may be especially challenging for smaller hospitals where their margins are already pretty thin.