On Health Care...
The country’s healthcare system is badly in need of reform – a reform that has sustainable solutions to improving access, affordability, and quality of care. During a global move toward consumerism, one must take into account the potential ramifications when reforming an issue that accounts for approximately 1/6th of America’s economy.
Republicans have shown a historical reluctance to focus on healthcare, instead favoring other issues at the forefront of the American consciousness. They all too often have passed the issue off to the Democratic Party to handle, or have discussed it solely as a cost center rather than as a value. However, with healthcare’s recent surge to the front of the national concern, the Republican Party has begun to clearly articulate what they view as necessary and immediate reforms that do not hinder choice and competition.
While the Republican and Democratic parties agree that every American should have access to affordable care, the Republican view is that the government should act as an organizer of the healthcare system – organizing an efficient market and securing its safety – rather than as an owner. The system should allow for greater choice and affordability for all while facilitating the development and sustainability of an efficient and patient-centered system of care. At the same time, it must be careful not to curb innovation.
There are a number of key points of reform that should not be delayed. First, the system should incentivize patient-centered, higher quality care; current reimbursement systems operate on a per-service basis and can spawn unnecessary tests and procedures, instead of targeting treatment toward the specific health needs of patients. Second, fraud and waste must be eliminated; for example, in 2007, $32.7 billion in Medicaid claims and payments were deemed improper. Third, innovation must be encouraged in areas such as health information technology. Most of the healthcare industry, specifically hospitals, still maintain outdated paper-based systems that result in a lack of communication and information sharing among providers. A high rate of medical errors is an unfortunate consequence (deemed the fifth leading cause of death in the U.S.). Fourth, the system must increase transparency for both cost and quality, wherein prospective patients are able to view infection rates across hospitals and choose where to receive treatment accordingly. Such transparency would help compel hospitals to meet standards of cleanliness and safety.
Other necessary reforms include promoting health care portability between jobs, focusing on prevention and wellness, ending frivolous lawsuits through tort reform, accepting applicants with pre-existing conditions, helping the poor by establishing a poverty line at the point of need, and encouraging the use of tax deductions, tax credits and health-savings accounts.
The most efficient way to create affordability is through reforms that improve the private market delivery of care and provisions of insurance. Many leading employers, such as Safeway, Whole Foods, Target and Wal-Mart are working to get better value for spending on health coverage for their employees. Allowing the private sector the freedom to adapt to best suit the needs of employees is crucial, but it is also true that current subsidies for job-based health insurance are not optimal in the way they discriminate against those with lower incomes. Because it is tied to the progressive income tax system, the invisible tax break for health insurance is most valuable to taxpayers in the highest tax brackets and least valuable to those in the lowest tax brackets.
Yet, the private sector is much more adept at innovation and evolutionary change than government dominated programs, and continued innovation is vital to progress in health care. The medical profession is moving toward patient-centered medicine, with micro-targeting of treatments tailored to the individual genetic code of individual patients. Advances in medical science demand that progress continue without being blocked by regulatory obstacles and restrictive payment services.
In the face of health costs that are supposed to double by 2017 and at the risk of squeezing out other public services provided by the federal and state governments, the challenges of expanding access to health coverage for the uninsured, modernizing our health care delivery system, and providing relief from rising health costs for private and public payers are enormous.
Confronting the systemic problems must not be delayed, but the approach to sustainable solutions must be careful and deliberate. Many nations, mostly smaller and more homogenous than the U.S., have found ways to provide healthcare to their citizens. While the U.S. can heed the successes and failures they have had, it would do well to remember that one size does not fit all and not be afraid to innovate and find unique solutions. As Michael Leavitt, former Secretary of the Department of Health and Human Services, said, “In a global market there are three ways to approach change. You can fight it and fail; you can accept it and survive; or you can lead it and prosper. We are the United States of America; let us lead.”
Simply expanding government involvement in the health care system is a short sighted and unreliable solution that does not play to America’s strengths, and it is not leadership. Leadership demands innovation and prosperity demands our continued commitment to free enterprise.
No comments:
Post a Comment