O F F IC E S PAC E
Using Technology To Put Physicians In Control
O
Wri t t en by D r. Lea h H o u st o n
ur healthcare system is failing. It costs more and has overall worse outcomes than any other industrialized nation. It is failing because those on the front lines of healthcare the physicians - have no say in how the system is run. Distributed Ledger Technology (DLT) - otherwise known as blockchain - has the ability to change that. DLT is about decentralization, disintermediation and eliminating censorship by removing the need for a third party in any transaction. We need no middlemen between us and our patients and this technology has an ability to make that our new reality. Our failing healthcare system is run by middlemen, 2 6 | A P RI L / M AY 2 0 2 0
so the potential of distributed ledger technology to disintermediate those middlemen yields potential to improve the failing system. Healthcare is one industry that has experienced increasing consolidation, vertical integration, and centralization over the years and it has heavy regulatory oversight. The slow regulatory capture over the practice of medicine has been achieved through laws that have been pushed through congress as outlined in the historical summary later in this article. As a result, healthcare has become radically inefficient, and in many cases borders on a monopoly. There are single health systems dominating entire geographic areas1, leaving
little to no choice for patients. Third party administrators are gaining market share and driving up the cost of healthcare through consolidation deals and price obscuring practices. Consolidation regulation and exploitation of the healthcare markets have created mal-aligned incentives. All of these things could be eliminated through decentralizing technologies like DLT. For example: Pharmacy benefit managers are merging with insurance companies, as with the recent 2018 CVS – Aetna and Express scripts and Cigna mergers.2 This creates a situation where the one controlling the supply of the medications will be negotiating the payment
