We are wondering whether the road to health care reform in America goes in circles. Employer-based coverage began in the 1940’s, followed by the creation of Medicare and Medicaid in the 1960’s and the rise of health maintenance organizations in the 1970’s. In between these major developments was the expansion of Medicare 10 years ago and periodic proposals for universal coverage. All of these health-care delivery systems have been revised, reviewed and second-guessed.
Here we go again. Congress is debating how to repeal, replace or possibly repair the Affordable Care Act, the 2010 law that became the focal point of much political acrimony. Since the onset of the insurance-based health care system we have today, there is one common theme: Well-intended policies have merit, but all have added administrative burdens on doctors and consumers alike. We are left with a frustrating and bloated bureaucracy.
The Affordable Care Act succeeded in addressing some of the worst aspects of modern health care, most notably creating a mechanism whereby people with pre-existing medical conditions could obtain insurance coverage and lower-income individuals could likewise obtain coverage largely through the expansion of Medicaid.
Where the Affordable Care Act came up short is adding yet another layer of bureaucracy and frustration, and worse, disrupting the insurance industry and affecting people’s access to medical care. Everywhere, there seems to be fewer patient choices as medical networks contract and insurers leave the individual market. There are also double-digit percentage premium increases and more government mandates affecting businesses and consumers. These same problems affect physicians as we are forced to abandon patient relationships we have had for years and accept more hassles to comply with costly systems that do not always advance quality patient care. Feelings like this, in part, led to this new environment where much of the law will be repealed.
Repealing the Affordable Care Act is easy. However, far more political difficulty lies in replacing it with solutions that ensure affordable and quality health care. There are some core principles that the new administration and Congress should develop. Centered on patient choice, affordability, accessibility, quality, responsiveness, and innovation, there is a road map to follow. We hope they will simplify the system to allow for transparency and simplified billing. Tired of getting 20 bills from a hospital that don’t make sense? So are we!
For years, front line patients and physicians have been left out of the reform process. Whereas, academics, economists and bureaucrats were favored. Perhaps well intentioned, some of these actors nevertheless relied on raw political calculation to create the system we know now. We hope congress can lead a charge to restore the doctor-patient relationship.
We will continue to wait to see what comes out of Congress. Our best guess is that the continued pressure to reduce costs will keep shifting to providers and, ultimately, you!
This is where we at Patient Premier can help. By providing an unbiased view of the quality of the options you have, you can make better choices. As we roll out data about the cost and value of your care, you will be able to find the best locations for your tests and procedures. Finally, we hope to one day help you make choices about the benefit of the tests and procedures you will undergo so you can have an informed conversation with your physicians.
We believe quality health care starts and ends with – YOU!