Sunday, March 26, 2017

Can Health Care in The U.S. Be Reformed?


Not with the health care delivery system and financing model that exists.

Tinkering around the edges and playing the little Dutch boy putting his fingers in holes in the dike to stop the water accomplishes nothing and doesn’t work. We find time and time again; this is the direction elected officials at all levels and policy wonks take while listening to the lobbyists for the different provider and insurer groups, who are more concerned about increasing their share of the trillion dollar health care industry than they are about patients.

I have worked in healthcare with the introduction of DRGs in 1983.

I have worked in healthcare during the 1990s and HMOs, capitation payment systems, the employment of physicians, the formation of health systems, provider driven insurance plans, etc.

I have worked in healthcare during the 2000s when the cost of medical care skyrocketed; the ACA was passed because nothing from the tinkering and experience of the previous 20 years worked.

I work and watch in healthcare during the 2010s, as we revisit the failed models of the 1990s and 2000s.

And here we are nearly 40 years later, with the same problems only bigger and more expensive.

We continue to “reform” a health care delivery system and financing model that is unsustainable.

This is just craziness.

The following is not a political statement but an observation.

For seven years we have heard the loud carrion cry of Conservatives doing the repeal and replace ACA dance. Now given a chance after all that wailing and whining the Republicans were: 1) never ready with any replacement; 2) incapable of articulating a coherent health care policy, delivery and financing model; and 3) are incapable of governing given a chance. Some old song. Same old story. Same old Washington.

The question is and always been, for which there has never been the national dialogue, is health care a privilege or a right? Then comes the consideration that also requires a national debate, how do we pay for care?

It’s not a matter of reform of the reimbursement models. It’s a matter of needing to change the health care delivery and financing model entirely.

Both parties only tinker around the edges bringing about unintended consequences that only make matters worse and solve nothing.

Understand that people have always gotten care, of which the cost of care was off-loaded onto the backs of healthcare providers, meaning doctors and hospitals. It is the medicalization of a societal issue. People do get care; it may be in an inappropriate care setting (ER) and at the wrong time, but care nonetheless.

Until the healthcare delivery and finance model is addressed at its root failure cause, and an honest national discussion is held, nothing more will happen except for the wild back and forth political swings of both parties.

Michael is a healthcare business, marketing, and communications executive, strategist and thought leader.  As an internationally followed healthcare marketing strategy blogger, his blog, Healthcare Marketing Matters receives over 20,000 page views a month and read in 52 countries.  He is a Fellow, American College of Healthcare Executives, Professional Certified Marketer, American Marketing Association and HubSpot Academy- Email Marketing, Inbound Marketing & Inbound Sales Certified. Post opinions are my own.

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