Tuesday, October 5, 2010

The Truth About Health Care Reform

It amuses me how simplistically the general public views Health Care Reform, one of the most complex issues of our time. For so many, it boils down to catch phrases and sounds bites such as socialized medicine and death panels.

Well ladies and gentlemen, we are fixing to undergo major, revolutionary change in the delivery of health care in America. That does not come from me. It comes from Tim Rice, CEO - Moses Cone Health System (whom I hear speak often). It will either be revolutionary change, as prescribed by HCR and which is rapidly being undertaken by progressive health systems across America, or we will be in the midst of a one-payer, medicare-for-all government system before you know it (my words, not his).

Hospitals in America are not sustainable in the current environment and at the current reimbursement levels for care they provide, according to Rice. In the near future, you will see major hospital consolidation and numerous hospital closings. You will begin to see hospital reimbursement based on the concept of doing less, not more, and being paid more for doing less.

You will begin to see Accountable Care Organizations (ACOs) made up of hospitals, doctors and insurers striving to be more efficient and effective. You will see Clinically Integrated Networks of providers electronically sharing information and better coordinating efforts. You will see Value Based Care and Evidence Based Medicine, where reimbursements will be based of performance, efficiency, and outcomes. This will, of course, be good for the patient, as well as the effective provider.

You will see the Medical Home concept using many more Physician Assistants and Nurse Practitioners. Why does an MD who spent 7 years in medical school see babies with ear aches and adults with sore throats?

You will see compensation for doctors more evenly distributed among specialities. You will see Primary Care Doctors more highly regarded, more widely recruited, and better reimbursed. You will see vastly more PA's and Nurse Practitioners. You will not see four open heart surgery centers within a 20 mile radius of each other.....as now exists in the Triad of North Carolina. You will see one Center of Excellence for open heart surgeries in the Triad doing them all.

I briefly describe only the tip of the iceberg. Health Care Reform is demanding a revolution in the delivery of health care in America. It is long overdue. People who have been working in the system at any level, in any of the ancillary industries, know this to be true. Keep on eye on it. If the revolution fails, our health care system will quickly evolve into a one-payer, medicare-for-all system. Only time will tell.

Who has EVER heard of an industry, being left uncontrolled in the free-marketplace, where the provider of the service or product 1) tells the consumer how much of the product or service they will purchase, 2) the length of time for which they will purchase it, and 3) what the price of the product or service will be? Please! It may be tweaked, but anyone how thinks HCR will be abandoned or repealed is misinformed. Tim Rice, and his likes, will not allow it, not to mention the fact that it would take two-thirds of both houses of Congress to override a Presidential veto of any repeal effort.

And, importantly, people should either drop the scare tactics/buzzword antics, such as death panels, socialized medicine, etc. or stay out of the discussion. Such trivia wastes valuable time and detracts. We do not have time to loose. The more informed will want to keep an eye on Wisconsin, Vermont, Connecticut, and Massachusetts, states moving rapidly or who already have many HCR provisions in place, such as exchanges, to watch for progress or pitfalls.

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