RESTORING THE PHYSICIAN/PATIENT RELATIONSHIP: AN INTERVIEW WITH
JACKSON HEALTHCARE'S CEO
Alpharetta, GA (October 15, 2009) - In October 2008,
Rick Jackson, Chairman and CEO of Atlanta-based Jackson Healthcare,
proposed a radical plan to revamp the healthcare system.
Since then, healthcare has taken center stage as the current
administration spearheads an aggressive reform of the current U.S.
Despite the diatribes, political rhetoric and propaganda that
have saturated the news, Jackson's core argument remains as
relevant as ever: the relationship between physicians and their
patients has been severed. Jackson believes this relationship
is the foundation for a healthcare system that is affordable,
accessible, efficient, safe and continually improving.
The following is an update on Jackson's beliefs regarding the
current reform efforts.
Has the current debate on healthcare reform changed any part of
your original proposal?
It has reinforced my belief that a wedge has been driven between
physicians and their patients. This wedge, consisting of
those entities which control the transactions between patients and
physicians, is the root cause of our current inefficiencies and
The real motive behind healthcare reform is to reduce government
spending on healthcare. It has nothing to do with
incentivizing an integrated system that rewards quality and
efficiency, while penalizing waste. The proposed solutions
for reforming America's inefficient healthcare system treat
symptoms, not the root problem.
What is the root problem with the U.S. healthcare system?
Physicians don't have an incentive to cut costs and reduce
patient utilization. Patients don't have an incentive to
manage their health and utilization. Actually, both are
rewarded for overutilization, which drives up costs. This
persistent cost inflation has brought us to a point where many
patients and their employers simply can't afford the cost of their
care and they can't afford to insure themselves against these
The current belief is the government can spend healthcare
dollars more wisely than physicians and patients in the
marketplace. Instead, efforts should be made to help patients find
and access the highest quality, lowest cost medical care in the
What are the components of your proposal?
First, we need to restore the relationship between physicians
and their patients by removing the barriers that exist between
them. Second, we should use existing technologies to expedite
patient care, while reducing administrative redundancies and
waste. Third, let's put physicians back in control of
medicine so they can practice high quality, low cost medicine and
self-police negligent practices. Fourth, we need a national
fee schedule that eliminates provider networks and recognizes
geographic cost of living differences. Fifth, we should use
an independently managed trust fund that incentivizes healthy
patient habits. And finally, we should reward physicians and
private industry for controlling costs and driving new diagnostic
and care innovations.
What current technologies do you believe would meet the
objectives of healthcare reform?
I believe the key is tapping computer and banking technology and
utilizing smart cards. A single smart card could handle
payment for medical services and house medical history, while
eliminating administrative overhead.
If every patient had a personal health smart card, similar to a
debit card with a memory chip, imagine how much safer and efficient
many of our medical transactions would be. The card would
contain a patient's eligibility, coverage level, deductibles,
protocols, medical history, care plan, etc. This card could
be used anywhere. It could compute co-pays, and authorize
pre-certifications and procedures for treatment. Medical
providers would be paid immediately and administrative costs that
currently exist in the system would be eliminated.
From a care standpoint, it could eliminate duplicate tests, labs
and radiology procedures. And it would serve as a central
repository for all medications a patient is taking, avoiding
medication errors and mismanagement.
How would medical costs and payments be controlled?
A national fee schedule should be created and contain
modifications based on the cost of living in each geographical
region. This fee schedule would be approved by physicians,
hospitals and relevant third parties, including actuaries.
Medical professionals could still differentiate their income by
service, efficiency and/or customer care. Other services that
are self pay, such as certain surgeries, private rooms, birthing
suites and the like, also could be added.
All physicians and other providers would be part of the same
system, eliminating the administrative expenses of managing and
supporting provider networks. This accounts for 1% to 2% of
Also, a healthcare reimbursement trust would be established and
managed by independent financial entities for beneficiaries.
Just as insurance companies do, all funds held in the trust would
be invested and all payors would pay premiums into the trust.
Actuaries would determine ongoing premiums based on desired
coverage and actuary tables would reflect higher out-of-pocket
costs for those whose lifestyles make them poor health risks.
What do you mean by "putting physicians back in control of
We need to trust physicians again. It's not fair to have a
few opportunists handicap the majority of physicians who practice
medicine for the right reasons. It's also not efficient to
have legislation or insurance clerks second guessing every decision
a physician makes regarding the care of their patients.
The first step is reducing malpractice and defensive medicine
costs. The present cost of malpractice and defensive medicine
is about 10% of healthcare costs. Physicians order
unnecessary tests in an effort to protect themselves from
The second step is establishing national physician review
panels. These are non-biased, independent peers who would
control protocols for patient care, define what's medically
necessary, approve exceptions and review malpractice claims.
How would your plan incentivize physicians and private industry
while protecting patients against unethical practices?
Healthcare systems already exist where physicians successfully
deliver low cost, high quality healthcare to their patients.
Mayo Clinic and Cleveland Clinic are great examples.
Physicians who create a better financial model to cut the costs
of medical and surgical care should be rewarded. The lowered
costs would reduce premiums.
Private industry should be incentivized to develop innovative
technology and pharmaceuticals in ways that make healthcare more
efficient and cost-effective. Without these incentives, the
future of medicine will depend on government and non-profit
scientists and grants. In countries that have universal
government healthcare, innovation has come to a screeching
Technology now provides us the opportunity to return physicians
to the practice of medicine. I believe this is the key to
improve the quality of care patients receive and make it affordable
and accessible to everyone
ABOUT JACKSON HEALTHCARE-Founded by healthcare innovator Richard
L. Jackson, Jackson Healthcare addresses the two largest challenges
facing healthcare today: finding the right people and delivering
the right information at the right time. The Jackson family of
companies provides clinician staffing, anesthesia management and
healthcare information technology solutions proven to improve
clinical and financial outcomes, as well as increase operational
efficiency. Jackson serves more than three million patients
in nearly one thousand hospitals each year. With a 43 percent
compound annual growth rate in revenue between 2005 and 2008,
Jackson was named among the "Fastest Growing Private Companies"
by Inc. 5000. In addition, Jackson has been recognized
as one of the "Largest and Fastest Growing Staffing Companies," in
the country by Staffing Industry Analysts and "One of
Atlanta's Best Places to Work" by the Atlanta Business
Chronicle. For more information about Jackson and its
companies, visit their website at www.JacksonHealthcare.com.