Obamacare is only first step for reform
Obamacare made a good start. It will save about 30 million Americans from being shut out of the system for lack of insurance. But much more needs to be done.
Obamacare is only first step for reform
by Robert I. Field, Ph.D., J.D., M.P.H.
Will we ever finish reforming health care?
Obamacare made a good start. It will save about 30 million Americans from being shut out of the system for lack of insurance. But much more needs to be done.
The prestigious Institute of Medicine issued a report this week showing what we are up against. It concluded that one-third of all medical spending in the United States is wasted on useless tests and treatments. That’s $750 billion a year in unneeded care. (Click here to read the report.)
The government pays for much of that waste through Medicare and Medicaid, which makes it a significant contributor to the federal budget deficit.
But the report contains an even more disturbing finding. It estimates that almost 75,000 people die each year from substandard and unnecessary care.
Where does all this waste and inefficiency come from? The reports identified a few major problem spots:
- One in three hospital patients suffers harm during their stay.
- One in five Medicare patients is re-hospitalized within 30 days.
- One in five patients reports that test results or medical records were not transferred to their doctor in time for a medical appointment, and one in four reports that a test had to be ordered more than once.
- Half of all adult patients report problems with care coordination, notification of test results, and communication among doctors.
- More than half of all patients do not receive clear information on the benefits and trade-offs involved in their treatments.
The report also recommended steps to addresses these problems. They include better information systems, improved clinical decision support, enhanced continuity of care, and increased performance transparency.
The hard part is figuring out how to put these steps into effect.
A few ideas are already part of Obamacare. One is creating accountable care organizations, which are groups of providers that coordinate different levels of care. Another is to pay providers for bundles of related services rather than for each one separately. They can then figure out among themselves how to allocate payments and services most efficiently.
Neither of these is a complete solution, but they may spawn experiments that could show what works and what doesn’t. The next round of reform can then explore ways to put successful strategies into effect.
Mitt Romney has promised to repeal all of Obamacare if he is elected. That means the experiments in making care more efficient would disappear along with everything else. He has yet to say what he would propose to replace it.
At stake are a chance to save 75,000 lives a year and to substantially cut the budget deficit. An issue like that shouldn’t be ignored.
Would you think that maybe the fear of predatory trial lawyers inflates the amount of unneeded care foisted on a patient? A doctor has to cover all his/her bases, so they may order tests and procedures that in a more rational environment they would not order. What you have now is lawyers in the room with the doctor and patient, and when the monstrosity of Obamacare takes full effect, politicians will be in there too. Is everyone comfortable with that?— jmc
What's sad is with Obamacare, Americans are now required to purchase a product or service which can increase in cost exponenially. So if your health care costs rise 200% you STILL have to purchase it or go to jail.
Thanks Obama! Thanks for putting an anchor around our necks and telling us its a life preserver!— Professor1982- The free market would have been the only way to control costs' But it may be too late. Check out this company if you don't beleive me: http://www.surgerycenterok.com/— Phishface
- @Professor1982 I am sure he would say you are welcome.— tildejac
- @Phishface Obamacare does make use of the free market, the plan that does not was the single payer plan. Obamacare mandates everyone participate and has a set of minimum benefits.— tildejac
- If you believe that, then you deserve to be on food stamps and welfare. — Professor1982
- Many tests are ordered by docs/hospitals on a CYA basis, primarily due to legal implications..Why hasn't this been addressed? To me, that's low-hanging fruit ready to be picked...maybe b/c the trial lawyers have too strong of a lobby?— Polecat_39
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