Company Clinics and the Ill Fitting Suit

This story about companies offering clinics for employees reminds me of my Uncle Abe’s story about the man and the new suit.

(Told originally with yiddish interspersed) This man goes his tailor and after much bargaining has a suit made.  When he goes to pick it up he finds one arm too long, the other too short, one leg too short and the suit too long.  He asks the tailor to fix it but the tailor suggests that he do the following.  He should simply extend one arm, pull in the other, bend the knee of the leg that is too short and pull up the suit a bit by lifting his shoulder (this was much better with Abe demonstrating the fitting with a smelly dead cigar in his mouth). ” There” said the tailor, as he showed the man the door,”it fits perfectly!!”

Our health care system is being distorted in various ways and politicians keep telling us how well it fits (“best system in the world, etc”).  However, there are significant objections to employer organized clinics: 

1.  The clinic would have fatal conflicts of interest.  Who is the health care provider working for?  Will saving money for the employer trump the best possible care for the employee.  The appearance of a conflict undermines confidence in the provider and clinic. 

2.  Confidentiality is essential and also impossible in such a setting. 

3.  Should an employee become sick and need to stop working who provides care? 

4.  We talk about choice as being desirable, where is it? 

5.  There is no continuity of care–although this is becoming a fleeting goal of our non system–a little like a suit we’re told this will fit perfectly.

There must be a better way.  Our country spends more, by 50-100%, than other industrialized countries for health care yet our health care statistics are mediocre and 45 million of our citizens have no access.  Are we educable?  Can we learn from others or must we stumble through a wilderness of ill fitting expensive solutions for another 40 years?

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