Divided We Fail

The fragile consensus and collective goodwill to enact transformative health-care policies may be on the ropes. Famed boxer Muhammad Ali employed the now legendary rope-a-dope boxing strategy to lure his opponent into a flurry of fists only to rebound and claim the ultimate victory. But health-care reform cannot withstand politicized pummeling, frivolous distractions and staged theatrics. Our mutual best interests lie not in defeating the President or simply getting legislation done. Rather, the goal must be to procure substantive change for the bulk of Americans, even incremental progress. Health care is a complex animal. And truthfully, we will not achieve the perfect health plan, but we owe our countrymen something better than the limited access and skyrocketing costs that plague our current system.

Suffice to say, all agree we can't afford to get it wrong. But neither can we afford half-baked solutions, inaction or indefinite postponement. Too much is at stake. Hence, we must find legitimate ways of curbing health-care costs while making health care available to the masses. Ultimately, the crux of health-care reform must ensure efficient and quality health-care delivery. And, this will require a radical departure from the way we practice and conceptualize medical care.

First, we must promote good health and provide incentives for prevention and wellness. In this aim, primary care must be well-funded, competitively reimbursed and prioritized. No one is hawking managed care and the days of HMOs playing gatekeeper, however we must devise a system that invests in health and well-being. The answer is not to pay physicians less, whether primary providers or specialists, but to bundle payments with good outcomes instead of procedures. Likewise, medicine cannot be practiced in a vacuum, which perpetuates abuse and redundancy. Rather, evidence-based medicine, electronic medical records, comparative effectiveness research and cooperative accountable care networks offer viable, promising alternatives. Changing systemic behaviors and revolutionizing health-care practices will not only weed out waste and inefficiency but enable savings.

In the short-term, more robust efforts must be made to lower the costs of prescription medications. The pharmaceutical industry can do more than its earlier pledge to reduce costs for select Medicare patients. The American public would be relieved to pay discounted prices as the norm and not as a rarity. Otherwise, fees should be considered to offset the price tag of reform. Additionally, government and private insurers should push patient-safety initiatives by refusing payment for preventable errors and readmissions, again emphasizing quality-care and streamlining costs.

We are a nation of dreamers. We spawned Martin Luther King, Jr. We landed on the moon. We are optimists and survivalists. We emerged from the Great Depression. We are doers. We are inventive and creative. Now is the time to show and prove. There is no need for rigid deadlines or inflexible ideologies, though a sense of urgency in the form of political resolve and public pressure are needed to deliver available, affordable, quality health care.

By Chris T. Pernell  |  July 21, 2009; 6:25 PM ET  | Category:  Health costs
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Posted by: weeson | July 22, 2009 11:54 PM
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