As you may already know, Affordability involves the integration of Value, Customer and Cost.  In Healthcare; Value = Health and Health Services, Customer = Patient/People, Cost = Price/Revenue – ‘Insurance (The typical payer)’ and Care Expense – Healthcare Provider.

The Value comes from the delivery of Care to Customers (Patients).  This occurs as a result of care delivery per patient requirements, needs, wishes and wants.  Healthcare providers are doing a fairly good job in this area.

The delivery of Value requires a Cost that is paid in terms of resources and expenditures needed for providing the care.  There exists a great deal of waste in this area (e.g.s; waiting, motion, defects, excessive processing including paperwork and additional procedures).  A focus on eliminating waste, increasing speed of responsiveness and improving quality would greatly improve performance.

The price paid, the charge for care, the rate for services and the overall cost for care is severely out of alignment in terms of Affordability.  In almost all cases and situations, care charges and rates are widely variable, inconsistent, and practically invisible to the patient.  The unique relationship in Healthcare between Care Providers and Insurance companies has created this off-balance condition.  In addition, the relationship of Care, Pharmacy and Insurance also complicates Affordability for Healthcare.  This condition looms as the greatest imbalance in Healthcare.  To resolve this, effort has to put forth to use Affordability tools, methods and approaches in; Insurance, Pharmacy, Healthcare Providers and Partners.

True Patient Focused Healthcare, with a genuine Affordability centered approach, should replace competing Physician Centered, Pharmacy Centered and Insurance Centered paradigms.