MedCity Influencers

American Healthcare Reform: Fixing the Real Problems

American healthcare reform is desperately needed. We’ve had massive changes in healthcare since the 1990s. […]

American healthcare reform is desperately needed. We’ve had massive changes in healthcare since the 1990s.

  • Hospital admissions have decreased (average daily census decreased 31% from 1980 to 2010, while the US population increase 36%).
  • Recent recent massive staff layoffs in leading medical centers and healthcare systems.
  • Closure of many hospitals, especially rural hospitals.
  • Hospital Outpatient revenues decreased from 7.4% of revenues in 1995 to 0.5% in 2011.
  • Percent growth of US healthcare costs peaked at 8.5% in 2003 and decreased to less than 4% in 2009.
  • Patient access to physicians visits peaked in 2005 – now decreasing.
  • High deductible health insurance plans increased from 5% of the market in 2008 to 20% in 2012.
  • Emergency departments are overwhelmed.
  • New US healthcare technology innovations are decreasing

 

Healthcare is a big, largely government and healthcare industry driven business consuming 18% of our GNP.  Our healthcare remains inefficient and costly.  It is becoming less responsive to consumer choices and to free-market forces.

Healthcare is highly complex and should be improved and simplified. We should reform it based on principles that most of the American people agree on:

  • Individual freedom of choice for health insurance
  • More universal healthcare insurance coverage
  • Insurance for pre-existing conditions
  • More efficient coordination of our personal healthcare, including health promotion and wellness programs for disease prevention and special programs for chronic disease management
  • Implementation of advanced health information technology systems to provide true transparency of healthcare information on costs, quality and options for services and procedures to facilitate more informed decisions
  • Convenient and timely access to healthcare providers that provide quality healthcare.

 

How do we get there?  We should move forward with meaningful healthcare reform to

  • Decrease exceptionally high administrative and overhead healthcare costs
  • Give providers more time with patients to practice more efficiently and cost-effectively
  • Involve more providers and patients in healthcare reform decision-making
  • Correct wide and unjustifiable variations in healthcare costs and quality
  • Provide data to support informed choices
  • Let choice and free market forces drive high value options.
  • Promote personal responsibility for health
  • Increase wellness and health promotion education programs
  • Increased incentives for healthy behaviors and improving individual outcomes
  • Implement Accountable Care Organizations, Coordinated Care Organizations and Patient-Centered Medical Homes
  • Build healthcare team-base approaches focused on patients with difficult, expensive problems
  • Improve quality of care and decrease costs by avoiding hospitalizations and emergency department visits

 

We should consider comprehensive, bi-partisan, market-based solutions — see “Michigan’s Approach to Medicaid Expansion and Reform” (N Engl J Med 2013, 36; 19: 1773-1775).  It’s a rational, cost-effective healthcare reform plan linked to free market incentives and innovations. We must work together to find better solutions for OUR most pressing healthcare problems.


Earl Ferguson

Dr. Ferguson is a healthcare executive, cardiologist, and preventive medicine specialist with major interests in telehealth and telecommunications and computer applications to healthcare. He provides telemedicine consults to remote areas of the high desert of California. He is Medical Director, National Rural Accountable Care Organization and Ridgecrest Regional Hospital; Executive Director, Southern Sierra Telehealth Network. He has served on numerous Boards, including California Broadband Cooperative, California Telehealth Network, California Health Information Partnership & Services Organization, and California State Rural Health Association. He’s the author of American Healthcare Reform: Fixing the Real Problems, published in 2014.

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