Why Health Care and Not Healthcare?

In the past decade various medical institutions have blended “health” and “care” into “healthcare” in their names and descriptions. Note that the same process has not yet resulted in “dentalcare” nor in “legalcare” nor in “nursingcare.” Only “healthcare” is the bastard union of its two constituent words. Why does that matter?

The hallmark of the last decade or two in health care has been the overpowering and acquisition of smaller medical practices and institutions by larger ones, gradually agglomerating into enormous networks that are fully corporatized. Individual practitioners have little influence, people as patients even less. Alleged “productivity” is the goal. Faster is better. More patients contacts per hour, more diagnoses and procedures per patient the goal, all to garner higher reimbursement.

Everyone Dislikes Healthcare

In this healthcare environment almost everyone is dissatisfied. People as patients, “providers” (formerly known as doctors and nurses) whether primary care or specialty, insurers, pharmacists and the government are all unhappy. Care is rushed yet expensive, access is poor, and quality is mixed and not guaranteed. These are the same defects I worked on in 1970-72 in the US Public Health Service.  Think of the McDonald’s fast food drive-in at lunchtime — long waits, limited menu, minimal personal contact, unhealthy outcomes. Healthcare is fastcare.

For me, health care is what every individual is entitled to. Thoughtful, accessible, unrushed personal interaction with a skilled physician or nurse who can listen, examine, test, explain, support, educate and, when needed, treat that person. I worked my whole career to provide such health care to a wonderfully varied spectrum of individuals. I formed my membership practice in 2006 to assure that I could continue to provide health care.

Unfortunately, current healthcare institutions don’t do a good job of providing the individualized health care we all want for ourselves and our families. And it is not clear how that situation will improve, even though I strongly believe that health care is less expensive than healthcare. I will comment further on the uncertain future of health care later this fall.