Bold, entrepreneurial idea to transform the health care system from within...

As a subspecialist in private practice, I've become increasingly frustrated by the absurdly inefficient, corporatized, and downright illogical health care system in the United States. It's safe to say that the focus of the system has drifted far away from the previously sacred doctor patient relationship in the direction of corporate profits, especially among insurance conglomerates. In fact, the large insurance companies nationwide have consistently reported insane profits annually--ironically, the implementation of Obamacare has been a financial windfall for these companies. I'm so sick of the ridiculous nuances of level 3 vs. level 4 coding, PQRS, insurance denials for medically necessary care, etc. I know I'm not alone in this respect. Just about every physician in private practice that I've spoken to about this subject expresses the same frustrations.

And the frustration extends well beyond physicians. Patients are extremely dissatisfied with the overall direction of the health care system. Premiums and deductibles keep going up every year, and yet mysteriously networks for physicians keep shrinking and denials are increasing in frequency.

It's an absolutely ridiculous system that doesn't benefit physicians or patients in the long term. Which brings me to an idea...

With so many disgruntled physicians and patients--I would venture to say in the MILLIONS--why hasn't anyone taken the bold step of creating an entirely novel system? As physicians, we have tremendous power to effect change, yet no one is DOING ANYTHING ABOUT THIS MESS! Why can't we launch a startup company that is an entirely novel take on health care insurance, one that overhauls the dynamics among patients, physicians, and third party payers?

The way I envision the system is the following:
--all patients enrolled in the insurance plan are essentially signing up for catastrophic care (i.e., coverage that will prevent financial ruin from medical illness). What's the appropriate limit on catastrophic care? That of course is subject to debate, but I would support a threshold that is income dependent (on a sliding scale). Obviously, a multimillionaire has a different threshold for financial ruin than a patient who makes $30,000/yr.
--all care up to the aforementioned threshold is out of pocket and involves a DIRECT transaction between the patient and his/her physician
--all elective care prices are advertised and transparent to promote healthy competition among providers and keep pricing to a minimum (ideally)
--mandated usage of generic drugs and generic medical devices to keep costs to a minimum, but if patients truly fail to respond to generics, then it's up to the doctor and his/her patient to make the decision about escalating to a proprietary drug (not up to some stupid bureaucrat in an insurance company for "prior authorization")
--forbid financial relationships between industry and doctors in the plan
--elimination of all the bureaucratic excess in the system. There will be no need for huge billing departments, because essentially the lion's share of all financial transactions will be DIRECTLY between providers and their patients. Only "catastrophic care" would require billing and closer oversight. This change alone would dramatically improve the efficiency of the system and reduce cost overall.
--implementation of a novel EMR that isn't focused on satisfying absurd billing requirements by insurance companies but rather on excellent patient care and research, with the potential to link the EMR to artificial intelligence software such as Watson. The EMR will be intuitive and aesthetically pleasing with an interface that physicians actually enjoy. The EMR should facilitate workflow and face time with patients rather than hinder these things.
--the insurance company as a whole is truly nonprofit. None of this craziness with the insurance executives pulling in MILLIONS of dollars in compensation.

I'd like to move forward with this idea. Maybe I'm being too idealistic but somebody needs to step up to the plate and CHANGE THE SYSTEM. We sure as hell cannot rely on the incompetent/corrupt politicians to overhaul the system, and insurance companies are making far too much money to even be willing to do the "right" thing for patients and physicians. The only people who can effect change are patients and physicians. We're at the heart of the health care system, and it's our responsibility to heal what is fundamentally broken.

Any interest on this forum? Any MD/MBAs with a similar vision and interest? If so, send me a PM. I have connections in various places, including a family member who is a hospital CEO and a family friend who is a president of one of the largest health care insurance networks in the country, along with many different colleagues/friends in various specialties.

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Bold, entrepreneurial idea to transform the health care system from within...