In his article today, Samuelson challenges President Obama's statement that "The status quo is unsustainable for families, business and government." He brings up the point that we, as a society, value expanding access because people tend to think of health care as a right (or at the very least, something that we should be able to provide our citizens as one of the richest countries in the world). At the same time, what makes our system unsustainable is not the number of people we cover, but the amount of money that we spend providing care for each person. Many uninsured currently seek primary care in the emergency room, one of the most expensive places to deliver care. Providing coverage for many of the currently uninsured and shifting their care to primary care settings will help to cut costs, but not enough to offset the cost of expanding coverage.
Our challenge now is to figure out how we can take the money we currently spend on health care and cover the uninsured, eliminate waste in the current system and provide better and more coordinated care for patients. There is no easy solution to this problem, but this must be part of any meaningful health care reform in order to create a more sustainable system.
Link to Article
Tuesday, August 11, 2009
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THIS IS NOT TRUE:
ReplyDelete'It is widely assumed that health care, like most aspects of American life, shamefully shortchanges the poor. This is less true than it seems.'
the poor may consume a fair share of economic resources yet they are woefully shortchanged in terms of outcomes.
Increasing coverage won't generate cost savings. Increased access yields increased utilization, resulting in increased cost.
ReplyDeleteDOCS Keep Half the Savings!
ReplyDeleteDOC 99, illustrates the paradox that reform faces. Solely increasing access will likely render cost containment ever more elusive. The answer of course is held by the doctors, as illustrated by Gawande:
‘“When doctors put their heads together in a room, when they share expertise, you get more thinking and less testing,” …
…The lesson ... is that someone has to be accountable for the totality of care.
And that will mean rewarding doctors and hospitals if they band together to form … accountable-care organizations, in which doctors collaborate to increase prevention and (to increase) the quality of care, while discouraging over treatment, under treatment, and sheer profiteering.
One approach, would allow clinicians who formed such organizations and met quality goals to KEEP HALF THE SAVINGS they generate.’
Yes but wait until the goal line keeps shifting. It's inevitable as the bills come due.
ReplyDeleteI'm afraid that unless the patients/consumers have a "skin in the game," cost savings will prove elusive.
ReplyDelete