One Year of Health-Care Reform: Fixing the Core Problems or Symptoms?

Posted by Peter Neupert 
Corporate Vice President, Health Solutions Group

(Cross-posted from The Washington Post Health Care Rx blog, which periodically asks Peter Neupert and a panel of other experts to weigh-in on efforts to reform the nation’s health care system.)

Will all of this year’s activity actually improve our health delivery system? I’m optimistic, but I’m also skeptical that the kind of comprehensive change we need to truly reform the system will happen.

My optimism stems from the American Recovery and Reinvestment Act of 2009, which included $36 billion in funding to encourage the use of technology by health-care providers. For the first time, the “meaningful use” rule-making describes technology as a means to improving health outcomes by using real-time data and quality reporting.

 

The reason for my hesitation is that I’m not sure that current legislation will fix the core problem or simply address a symptom. If we don’t get to the root cause, our entire health system could follow Medicare, which is projected to go bankrupt in a few years, even after increasing taxes to support it. And there are really only three approaches to preventing it from going bankrupt: cut benefits, grow GDP faster and improve value (more ‘health’ for the same dollars).

Everyone (citizens and politicians) wants more and better ‘health’ — a better health delivery system, more prevention, more therapies to cure complex diseases, more and better doctors. But more ‘health’ is not free and our challenge is to reduce the waste in our current system to get more ‘health’ for the same amount of money. This is clearly very hard, from both a legislative and practical implementation perspective, but it needs to be done.

After all, more health insurance does not necessarily equal more ‘health’.

If we are truly to address the health-care issues before us today, we must start by asking ourselves:

  • What framework or system of rules, incentives, relationships, markets etc. will lead to more health for Americans over time?
  • Should society provide unlimited health-care to all? How should we finance this economic responsibility?
  • What role do individuals play in being responsible for their own health — paying for it, beingaccountable for healthy or risky behaviors and consuming health delivery resources?

Most people close to the debate recognize it will take several years to get reform right. I hope that we continue to work at addressing these core issues.

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