Tuesday, July 04, 2006

On Gratification

It is always gratifying when a recognized authority expresses an opinion that matches your own.

Paul Ellwood was for years one of the gurus of health care. Among other things, he is considered the father of managed care and is given credit for inventing the term Health Maintenance Organization. He was influential during the Nixon years when HMOs were formally promoted as a matter of national policy.

In its cover story, the June 19, 2006 issue of Modern Healthcare featured four “Father Figures” of major movements in health care. Ellwood was one of them.

When asked about the future, here is what he said:

“The next president’s most compelling domestic problem will be unaffordable, unaccountable and inconsistent healthcare. The problem cannot be solved unless the parents of the next health policy give birth to a healthcare system made up of fully integrated groups that can be held accountable for their patients’ health.

One of the key missing elements remains the assurance that the medical care we’re buying actually works. The closest thing to that right now are the plans that pay providers something extra for doing the right thing, but that kind of tool is not sufficiently powerful. My feeling is, if they’re not doing the right thing, they shouldn’t be paid.

The government agencies that buy healthcare such as Medicare and Medicaid need to get out of the business of attempting to manage healthcare. Instead, we learned from HMOs that the U.S. needs a permanent entity that can follow and subtly gauge and influence the ability of a less fragmented healthcare system to cost-effectively produce health.”

I couldn’t have said it much better myself.

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