Opinion: Bigger is not Better. The Quality of Healthcare is about Caring, Not Size

Aug 02, 2022 at 09:15 pm by pj

By Raegan Garber Le Douaron, President, WeCare tlc

Social media is all abuzz about the recent purchase of OneMedical by Amazon. I want to add my two cents to explain why this does nothing good for health care....and those paying the bills (read: patients AND employers). 

I am also speaking to everyone who has heard of, invested in, or is considering an employer-sponsored health system. The recent moves in our industry have not been beneficial to you or your health plan members. You do not have to accept this. There is a better way.

Let's start with the concept that is an anomaly in the world of "normal" business—when an entity pours a large sum of money into health care, costs go up, NOT down. Think of every time a health system builds a new hospital, imaging center, etc. The price you pay for health care in your area goes up. So Amazon (a publicly traded company) pouring a large sum of money into a failing company does not necessarily bode well for patients or employers. 

There has been a consolidation trend in our corner of primary care, mainly by tech or tech-backed companies. These moves introduce a few problems, the first being that they are publicly traded and are accountable to their shareholders. Who are they not responsible to? You, the person paying the bill and/or receiving the care. What you see instead is merely a continuation of misaligned incentives. 

The second reason is an over-reliance on technology as "the answer" in health care delivery. OneMedical is a virtual delivery system of care. And virtual care is great. We often use it to bridge gaps in accessibility and to add convenience. But overly relying on virtual care does not give you the improved outcomes to bring about lasting improved health and overall decreased costs—another missed opportunity.

Health care delivery is typically not a good business investment on its own. An example is OneMedical's staggering $90.9M in debt, even with $254.1M in revenue. We would be promptly fired if you and I ran a company with those numbers. 

The good business investment of primary care lies in its downstream effects. Proper preventative primary care will result in better outcomes and lower costs over time. If (and I repeat if) appropriately done. The United States does not do primary care well, and these latest moves do nothing to help move the ball forward. 

But we need to if we want to do something about the fact that health care is 19.7% of our GDP, yet we have the WORST outcomes in the WORLD. The U.S. has never had the right conversation about health care, and this latest purchase is no different. It’s another missed opportunity. 

Consider these stats from the Commonwealth Fund:

Countries that have the best health outcomes and lowest cost have these four traits in common:


  1. Offer universal coverage and remove cost barriers
  2. Invest in primary care to ensure high-value services are available
  3. Reduce administrative burdens that divert time, efforts, and spending
  4. Invest in social services

My advice to you is this: Make sure you have aligned primary care accountable to you. Make sure your primary care partners are operating on data to help pull patients in to close gaps in care and ensure continuity of care. Ensure payment models are aligned to incentivize all to provide the right care, at the right time, for the right cost. And please, please, pleasehold your primary care provider accountable to show you the data of how they are impacting your health plan cost and improving outcomes. 

Sections: Clinical

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