Now, I've visited ProMedica facilities. I've known people who have received care from them. As far as I know, they deliver fine care. But, well, let's put it this way: I live in southwest Ohio, about a hundred miles from their service area, and no one here is longing for ProMedica to come to our market. So I doubt that many people in China are excited about ProMedica coming, not the way they might have once looked forward to their first McDonalds or Starbucks.
Or that they might view, say, The Mayo Clinic.
Other hospitals are racing ProMedica to get into China. WSJ noted that Brigham Health, Mass General, and The Cleveland Clinic are all working on projects in China, either with partners or providing consulting expertise.
International business is nothing new for some U.S. hospitals. The Cleveland Clinic has been drawing wealthy patients from overseas for its heart and other programs for decades. They now have programs catering to them, as do Cedars Sinai, Johns Hopkins, Sloan Kettering, and UPMC, to name a few.
The Cleveland Clinic and UPMC, both of which are well-known but primarily regional, non-profit chains, have had international locations for years. Crain's Cleveland Business reports that The Cleveland Clinic is now planning a London location. It would appear that crossing the Ohio-Pennsylvania border is harder for both systems than crossing the Atlantic.
 |
| Cleveland Clinic London is expected to open in late 2020. CLEVELAND CLINIC |
- Boston-based Steward Health Care System's efforts in Malta;
- UPMC's interests in Italy, Ireland, Kazakhstan and China;
Health plans like UnitedHealth and Aetna are also investing in overseas opportunities.
- "Other U.S. hospital corporations have struck deals in the U.K., Colombia and France in recent years."
The Gold Rush is on.
In a way, it is fitting that we're exporting our healthcare system. First we exported agricultural products overseas. Then we exported our unhealthy fast food restaurants and packaged foods. It is no wonder that the rest of the world is now catching up on chronic conditions like obesity and diabetes.
First we help make them less healthy, then we offer to treat them -- for a price.
Perhaps it is not too surprising that hospitals are looking overseas. WSJ also reported that median hospital operational cash flow margins fell to the lowest point since 2008, when we were in a deep recession. ACA was supposed to be their salvation, but its positive effects are diminishing.
The international allure for hospitals is money; specifically, wealthy, self-pay patients. That's who they've been drawing to the U.S., and that is a common theme in where they are locating -- e.g., London, Dubai, Rome. When they go in to China, one suspects that they'll be more interested in Shanghai than Longhua.
If hospitals can get overseas self-pay patients who can afford to pay "charges," that's got to be more appealing than fighting with state Medicaid programs about reimbursement, or waiting for the latest hit on revenues from CMS. You can't really blame them.
There are not a lot of comparisons international healthcare systems in which the U.S. system comes across very well (e.g., last year's The Commonwealth Fund report). We pay wildly more, for uneven quality and mediocre outcomes, and with too many barriers to access. And yet other nations are still interested in importing some of what we do.
It is true that we can get some of the best care in the world here, but it is not as though you'll necessarily benefit even if you happen to live near a distinguished hospital system (e.g., Baltimore or Cleveland). It helps to have lots of money, and/or to be really sick.
It may be that hospitals won't find the overseas markets as lucrative as they are hoping for. There are only so many wealthy people, after all.
I have no trouble with people and/or organizations making money, even in health care. If a for-profit hospital or other health organization thinks it can make more money overseas, more power to them. Let's just not pretend they are about serving patients, either here or there, except perhaps as a means to their end.
I don't even have a problem with non-profits making enough money to further their mission, but I have a problem with how non-profit health organizations sometimes don't use those profits to serve the community good. I really have a problem when non-profit health organizations use the reputation that their tax status has helped them build to not only invest in more businesses but also to do so overseas. That's not the purpose of those tax breaks.
We have plenty of innovation that our healthcare system can export. Techniques, devices, digital strategies, VR/AR/AI -- we're pretty good at these. Delivery of care, not so much. Pricing and financing of care -- we probably shouldn't even want to talk about them, much less try to export them.
I wish other countries wanted to import how our community health centers deliver care to disadvantaged populations, or how managed Medicaid plans assure financing of care for those populations. Those are things to be proud of, although we don't seem to be. I wish we had better successes in keeping populations of people healthy that we were exporting.
Instead, we're exporting how to treat the 1%, and how to treat people who get very sick. Because, after all, that's what we're good at.
For any U.S. healthcare organization looking overseas for opportunities: hey, there is plenty to do here.
No comments:
Post a Comment