Anthony Wunsh, president and CEO of Medical Pay Solutions, asked this question to thousands of industry stakeholders in about 20 LinkedIn groups that included Healthcare Executives Network and Society of Physician Entrepreneurs. A lively and insightful discussion has ensued, with suggestions of everything from mandatory and universal coverage to eliminating insurance for services costing under $10,000.
Wunsh says he is translating the 500+ responses he’s gotten into categories and tallying up the results, with the intent of making them public once he’s done.
Until then, here are five of the top must-dos for successful healthcare reform that I gathered from reading some of the discussion threads:
More accessible and portable patient data, which enables improved communication among providers. A number of respondents mentioned interoperability of EMRs and the importance of tying lifelong data together via HIE as critical aspects of improving continuity of care and reducing costs. Many also alluded to the PHR as a powerful tool in this endeavor.
“[We need] patient controlled PHR technology that liberates medical data from the dead-end silos and black holes of the medical industrial complex,” writes Jim Meehan, a physician-entrepreneur in Oklahoma, in the Physician Entrepreneur group. “These next-generation PHRs should integrate with wireless medical devices, accumulate live data (not lab report PDFs), return it to the patient in a visually understandable and actionable format that enables self-awareness, pattern recognition and self-regulation.”
Tort reform. No surprise here — protecting doctors from frivolous lawsuits and discouraging excessive testing is a big concern within the industry. The posters had a variety of ideas on how to go about this. One, for example, proposed independent review boards made of doctors, lawyers, actuaries and support staff to review each potential malpractice case based on circumstance. Another proposed reform whereby a provider can be sued only with proper documentation of deviating from protocols.
Focus on prevention. How? Some suggested a universal payer system. Others suggested stepping outside the payer-provider-patient-employer box and targeting the food industry or public education.
Insurance incentives for low-cost users, in order to instill a sense of personal responsibility in maintaining one’s health. “Structure premium pricing that puts the consumer of healthcare FIRST,” writes Phil Bolger, a health IT executive in Nashville.
Or, eliminate employer-based benefit insurance all together. Michael Kelley, a pharmaceutical account exec in Nebraska, suggests: “Allow for catastrophic or supplementation as a benefit, but get back to an insurance-based product rather than benefit-based product. Puts consumers closer to costs of care and creates wellness-generating incentives and behaviors.”
Another interesting comment suggested portable insurance for consumers. “Let me ‘own it’ rather than an employer”” writes Kevin Cullis, a business blogger in the Denver area. “Also, allow an employer to be able to subsidize my health insurance through available tax deductions.”
Aligned incentives. Not much debate on this one. People want better pay for quality outcomes.
I ran these five points by Wunsh, who agreed that these were top concerns, but added a few other notably popular ideas: allowing insurance companies to compete across state lines, standardizing claim processing among all payers and implementing a single-payer system.
Just talked with my local state representative this morning about my idea which you posted about. She said when she proposed my type of idea a while back, all of the lobbyists opposed it. My thought as to why? Because they (labor unions, businesses, etc.) could not longer control their employees and keep healthcare "hand cuffs" on them and keep them from leaving their businesses. Isn't that against an individuals choice that benefits them? So this is those organizations which are restricting the marketplace for competition, which does more to lower costs than any other ideas.