Monday, July 27, 2009

Thoughts on Health Care Reform from Wesbury

Stuart Wesbury, long-time friend and colleague, former association executive and academician, and regular reader of this blog has composed the following letter-to-the-editor. Although I don’t agree with all of it, I deem it to be is well thought out and worthy of consideration.

Finally, the Congressional Budget Office has cleared the air. We now know that the current health reform bills will significantly increase health care costs. Another piece of insight that must be understood is: reducing a Medicare payment does not save the health care system anything. The government may pay less, but the cost of providing that service has not changed. Instead of spending more money, our Federal government must pay attention to things it can do to REDUCE costs! This can be best done by reducing the demand for health care services. So it is time to get started. Specifically, what can government do? Let me count the ways.

· Encourage cost savings through primary prevention by providing financial incentives for individuals to live healthy lifestyles. Congress must promote patient prevention rewards and abolish the concept of community rating. Patients’, practicing healthy behaviors, should be allowed to earn cash incentives or insurance premium discounts without limit. The result? healthier citizens, utilization of fewer services and less cost.
· Secondary prevention (early detection) and tertiary prevention (teaching individuals how to care for their chronic diseases) must be supported. Cost benefit studies and development of better educational techniques are two more items for the research agenda. Primary prevention is still the most likely preventive methodology to produce significant savings. However, secondary and tertiary prevention hold much promise.
· Re-direct significant health care research dollars to explore the best way to deliver effective and economical care. Remember managed care and HMOs? They worked! Kaiser–Permanente, Group Health and my care provider in Arizona, Cigna Staff Model HMO. All of these and more are highly rated and collectively, they spearheaded lower cost efforts for years. They were and are successful. If this is what is meant as “accountable organizations,” let us have many more.
· Another spot for more research is for comparative treatment evaluation. We know that medical practice varies greatly from one area of the country to another. What treatment is best? Let us learn more about outcomes and costs. The potential of government edicts concerning treatment selection cannot be a hindrance to getting facts. Deciding whether to muzzle research results should not be on Congress’ agenda. Get the information.
· Attack Defensive Medicine. Up to 20% of our nation’s health care costs are the result of a tort system out of control. Excessive testing, un-necessary treatments and non-productive pressure on physicians and the health care system are a national disgrace. Injured patients must be cared for. But, today’s roulette wheel of justice is a disaster. Community systems of injury adjudication must be created and put into place. Incredible savings will result and all deserving patients will be cared for.
· Eliminate state mandates and allow national sale of health care policies, period.

Let’s face it. Just spending more money will make our heath system problems worse. Taking more money away from selected segments of our population by taxation will negatively impact investment and innovation. Why not simply work to make health care less expensive. Who loses?

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