Healthcare Enterprise Zones

This is a proposal by Arnold Kling and Nick Schulz

These would be areas where entrepreneurs could set up healthcare delivery systems without any rules concerning what license would be required to engage in any particular activity. Perhaps medical services could be delivered by workers with fewer credentials but more rigorous on-the job training.

Healthcare providers would be accountable for the quality of their work, not for the certificates hanging on their walls. Instead of forcing work rules on the healthcare system, consumers and the government should hold innovative healthcare organizations accountable for results. If their success rates and error rates compare favorably with traditional hospitals and medical practices, then these alternative models should be free to remain in operation and to continue the process of redesigning healthcare.

Comments (6)

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  1. Mike Ainslie says:

    This could work if control of the money was placed in the hands of the patients. The system now lets insurance- public or private decide. Without patient control of the money and they would be the best judge of cost/quality, this would not work.

  2. Paul H. says:

    Great idea. I like it.

  3. Devon Herrick says:

    This would be an interesting experiment. However, I suspect it could take a generation to refine the business model through numerous iterations of trial and error. If you read Paul Starr’s book The Social Transformation of American Medicine the current model took more than a century to form. The third-party payment system has been around for 60 years.

  4. Buster says:

    Walmart created a logistics process where high quality goods are sold by mostly a labor force with few other opportunities. If a corporation can import, ship, distribute and sell 100,000 different goods cheaply before they perish, Healthmart could probably figure out a system with lesser credentialed providers who were highly train in only a few things. It might be primary care where high tech machines are used to analyze diseases and conditions from bodily fluid. Or maybe firms could management of chronic conditions. There is no reason to believe the current structure of licensure and self-regulation of the medical profession is necessarily the only or even the optimal way to manage medicine. My problem with enterprise zones is so few people would be in close enough proximity to patronize them. An alternative would be to establish a dual track of clinics. One type if the standard we know today. The other is alternative credentialing where a corporation, practice or partnership takes responsibility for the quality and the credentials.

  5. Brian Williams. says:

    What about creating these “Health Enterprise Zones” on Indian reservations?

    Casinos can’t be the only business worth building on a reservation, outside the reach of the government.

  6. Linda Gorman says:

    What about making the entire United States a health enterprise zone?