Newtown, CT – October 28, 2016
Inertia is resistance to change in motion and you can’t overcome it. Even when you’ve got something moving, it still exerts resistance to change – While this might be depressing to many of us who deal with institutional inertia every day and try to “overcome” it, it also offers an essential lesson in making lasting change: You must never stop pushing. When the motion of change is engaged, immobile objects start to move, pushed by the force of that change. Their mass, however, exerts resistance, which is their natural inertia, and the bigger the mass, the larger the inertia and the stronger the force has to be. Earlier this week, at the VBID Summit in Ann Arbor, the forces of change and inertia were in full on display, and for those of us who have been pushing for change, the squeaks and squeals of the heretofore immovable masses were an encouraging sign. On the side of change were states and cities that are putting into motion strong reforms on payment and benefits, exerting significant market forces. Those local efforts are joining the national ones, resulting in the motion of markets. The previously immobile objects, represented at the VBID Summit by Big Pharma, were clearly reeling from the changes afoot. It was amusing to watch as one after another blamed every other stakeholder in the industry for the rising prices that have led the forces of change to push for a new market order. “Why are you focusing on us?” whimpered one mouthpiece, “after all, we’re only 15% of the total health care spend. Focus on the hospitals and physicians, they’re the other 85%.” Take solace, dear apologist for Mylan and Turing and the other pigs at the trough, hospitals and physicians are all feeling the effects of motion, and now it’s your turn, and none too soon.
What this means to you – As the effects of market change caused by the combination of value-based purchasing and consumerism continue to play out, we can’t fool ourselves into thinking that we have “overcome” the inertia of the agents of the status quo. That inertia, the resistance to motion, will never stop, because what’s at stake (beyond the laws of physics) are several trillion dollars in revenues and hundreds of billions in profits. What must motivate us to continue exerting a constant and unwavering force for market change is the realization that average consumers in the United States are at ever-increasing physical and financial risk. The rate of price increases, which is completely unjustified and unjustifiable, has resulted in the burden of health care costs on an average family to go from 6.5% of median income to over 10% in a decade. In other words, one of every ten dollars earned is now being sucked up in health care expenses. That means less money for housing, less money for retirement, less money for a child’s education. Employers, whether big or small, combined with state Medicaid agencies will ultimately decide the velocity of change because they are the only ones that can contractually obligate health plans to migrate payment from fee-for-service to value-based. And the laws of physics are clear that any reduction in the force moving the markets today can potentially cause the motion to stop altogether, crushing hundreds of millions of Americans in the process.