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
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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.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
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.
