Those of us who look on in bewilderment at the US ability to commercialise anything will find such brash commercial solutions for human suffering as disease management distasteful. This week's BMJ carries a critique of the US “health” marketplace, in which “disease management” is the next big thing.
In any such development there will be good and bad, and these are to be discussed at the disease management congress later this year (www.nmhcc.org/events.disease.html). Unsurprisingly, this will feature “insightful keynote discussions by leading industry visionaries ... for timely information to put your institution at the helm of the industry—and ahead of your competitors.”
The Disease Management Purchasing Consortium and Advisory Council advertises its wares at www.dismgmt.com/. It advises health maintenance organisations, which purchase care for populations, on how best to deal with disease management organisations, which specialise in dealing with populations with particular diseases. Its home page conjoins the jargon of software with that of healthcare management in a singularly unfortunate way: “CLICK HERE to learn about the Consortium's newest killer app, total population management.”
But the site's depths make for some very interesting reading. At www.dismgmt.com/frame11.htm is a remarkable essay modelling urban poverty as if it were a disease, with a coincidental upbeat view of the concept of disease management. This, the site claims, will save health maintenance organisations money by relying on the self interest of corporations which are paid only if they save money on hospitalisations and other costs. It is also claimed to be in the best interests of those with chronic diseases, who do best when their self management skills are boosted while living within their own homes.
“Self management” is also claimed by the anarcho-syndicalist libertarians for their own—see http://members.xoom.com/autogestion/. Can they and corporate America really be saying the same thing?