Reflections on the Inauguration
I must admit that I am not a supporter of the Affordable Care Act. Although I agree that the way healthcare is delivered and paid for in our country is not sustainable, the mandates of the ACA are untenable. Some healthcare engineers are claiming that they have the solutions to make healthcare more affordable, more accessible and of higher quality while improving the ability of those that deliver the care, the physicians, nurse practitioners, physician assistants, nurses and case managers to do so.
Some tout that repealing the ACA will result in the loss of coverage for over 20 million Americans. Many believe that the current administration is incapable of creating a solution that will result in a better solution.
It is of no surprise that healthcare is an imperfect market. The third party payor system has resulted in moral hazard; the additional health care that is purchased when persons become insured. People will demand all the healthcare they can get because they are not paying for it in the traditional sense. In addition, the technological imperative has driven organizations across the country to buy the latest and greatest technology and offer it to patients who demand it. The result is care that has become costly to produce and difficult to access.
The current solution focuses on improving quality to lower cost. Quality in healthcare is defined as safe, patient-centered, timely, effective, efficient and equitable. Both the government and commercial insurers have created overly burdensome programs that are based on parameters and metrics that purportedly are aimed at improving quality. In order to collect the data to support these metrics, healthcare was forced to adopt electronic medical records that were not yet ready to be operationalized, in order to collect this data. At the end of the day, we ended up with an inefficient electronic medical record that cannot or will not change to meet the workflows of the providers. In addition, the data collected is focused first and foremost on lowering cost and not on improving quality.
Obamacare forced the cart before the horse.
It is time to rebuild our healthcare system into one that is uniquely American; one that follows free market principles. Healthcare in America must and should be of the highest Quality anywhere in the world. President Trump told us today that “From this day forward, a new vision will govern our land…We must think big and dream even bigger.” So today I am dreaming big that insurers and providers can work together to rebuild a healthcare system that puts patients first and allows our providers the freedom to take care of them in a manner that constantly improves real quality. Let’s put the horse back in front of the cart
Emergency Physician
8 年Well stated. Time to focus on systems that put the well being of patients first. We also need a shift in the unrealistic expectations of the the American people that stops excessive spending at the end of life.
President, KRE Consulting, Inc.
8 年Rob - I agree with you in principle. The big question is what is Congress going to replace it with? I am less confident than you that they will come up with an improvement. I'm hoping your big dreams come true - we shall see.
OpEx Change Agent at Trane Technologies
8 年Great summation of the morass that was created from the mess we had before the ACA. Looking forward to seeing the corrections in our system which should include big Pharma, litigation, and insurance companies. It's funny, all the "institutional ills" that Pelosi, Obama and Reid railed against are the very ones that were able to (in many cases) greatly enrich their executive staffs with large bonuses off the backs of "We the People."
Vice President, Consulting Services
8 年Looking forward to change.