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Time to Get Practical
The President faced a tough audience at the American Medical Association. Many doctors have reached the end of their ropes with Medicare and Medicaid because of low physician payment and oppressive red tape. Obama's proposals have raised the same concerns.
Most of the President's comments were nothing new, and may have left the average physician (and patient) still be wondering exactly how and when his ideas will become reality. However, the speech signaled that the Obama team may be getting more savvy. The President mentioned several practical steps to implement change:
•Medicare funding could be altered to reward doctors and hospitals that collaborate to improve quality and cost--as happens in some health systems already, including my own at Henry Ford.
•The primary care crisis can be helped by changing payment for physician services and for their education. Both remedies are unpopular--but every doctor knows they must be done.
•All provider payments should be based on performance and outcomes--not some arcane economic formula like the sustainable growth rate (SGR).
•Poorly coordinated care results in readmissions. Focusing on that problem alone would help patients get better services while reducing costs
•The government should use its purchasing power to drive down pharmaceutical costs. If the drug companies need research and development dollars, let's fund them through the National Institutes of Health or other research pathways--not through retail pricing.
Any of these proposals would be a healthy start but each would be difficult and require careful implementation.
Therein lies the rub. Health-care reform is a marathon, not a sprint. It requires careful planning and strategy. As every marathoner knows, starting off too quickly is a serious mistake. I hope this administration knows racing tactics.
By
Mark Kelley
|
June 15, 2009; 8:10 PM ET
| Category:
Health Care Reform
,
Medicare
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Posted by: Maggie Mahar | June 16, 2009 4:38 PM
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Mark-
I agree, and I think the President does understand that rolling out a national healthcare plan will take time.
The administration definitely wants to pass legilsation this year. Though I think it may take more than one bill to accomplish everything they hope to do.
One hopeful sign in yesterday's speech: the president talked about phasing out payments to compensate hopsitals for treating the uninsred over a period of time "as the uninsured are covered by the program." This indicates it won't happen all at once, on a Tuesday in December.
From the beginning both the president and Peter Orszag have said that the goal is to have universal coverage "by the end of the president's first term."