Good deed turns into good business

Marketplace reports on a doctor in Seattle who is offering his recently laid-off patients care at a reduced cost:

It became clear to Rosenfield the economy was affecting his practice. So he sent out letters to his patients and introduced a new payment plan for those who lost their health insurance. They don’t get billed. But they pay upfront, usually between $40 to $60 for each visit, depending on their financial situation.

In the process he has stumbled upon something interesting:

Rosenfield was bracing to take a financial hit. But it’s actually saving him money. It’s reduced the amount of paperwork he has to file. And since patients pay him directly, he spends less time chasing after insurance companies for reimbursements.

Consequence of economic downturn: the growth of local

One economic downturn reality beginning to reveal itself: an emphasis on local.

Peggy Noonan in Friday’s Wall Street Journal:

Dynamism has been leached from our system for now, but not from the human brain or heart. Just as our political regeneration will happen locally, in counties and states that learn how to control themselves and demonstrate how to govern effectively in a time of limits, so will our economic regeneration. That will begin in someone’s garage, somebody’s kitchen, as it did in the case of Messrs. Jobs and Wozniak. The comeback will be from the ground up and will start with innovation. No one trusts big anymore. In the future everything will be local. That’s where the magic will be. And no amount of pessimism will stop it once it starts.

There’s a trust composed of transparity at the local level.  A comfort level that can’t be found elsewhere.  Relationships are more familiar.  Business goings on clearer.  At at time when comfort is at a premium, local just feels better.

Implications for health care delivery are yet to be discovered (there is one nationally integrated system, but some are close, which very well could be positive).  Concerns could also arise, possibly regarding national expansion plans or organizational motivations.  We’ve yet to discover how big is too big in health care delivery (except for maybe this place).

An emphasis on local could certainly be a welcome development.  Shop local campaigns are blossoming.  Growing food locally is rising in popularity, eating local too.  Health care has almost always been delivered locally; maybe it needs to stay that way.  Who better to understand the health care challenges of a community than local delivery organizations?