Thursday, August 27, 2009

Change Your Strategy, Mr. President

Emerging consensus is against another health plan sponsored by the federal government.

There is already much oversight at federal and state levels of all insurance programs, yet these programs experience unsustainable cost trends. Medicare, Medicaid and the Federal Employee Health Benefit Plans are modeled after private insurance plans and they do not work economically. In the instances where profit incentives have been removed from government-run programs such as the federal employee health plans, the trends in these plans are not significantly different from private insurance plan trends.

One sustaining aspect of our health system is the belief in the patient/doctor relationship. This bond between patients and their physicians continues to survive insurer, government, and other third party interference. This patient physician bond must be strengthened in any successful strategy for change.

Instead of continuing to list all that is wrong with American Health and coming up with new unproven expensive plans for change, the president should focus on practical ways to improve quality in health care by leveraging our patient physician bonds.

First he has to communicate the message to everyone that on average clear evidence indicates that Americans receive substandard basic health care. This circumstance is driving up our health costs because without basic care we often develop catastrophic expensive illness. Less than 50% of all Americans participate in early cancer detection programs whether or not they have insurance coverage. Similarly for diabetes, many people develop complications of stroke and kidney failure because they do not follow basic treatment recommendations of the American Diabetes Association.

Physicians and their patients, contrary to their perception, do not have useful up to date information when making health care decisions that involve everyday health care.

One powerful source of information to improve health, and strengthen physician and patient bonds has been available for years yet not shared. Medical claims, laboratory results, and pharmacy data stored in health plan administrators’ computers (Medicare, Medicaid, Private Insurers, and Third Party Administrators) are available and able to support individual and doctors efforts to narrow quality of care gaps. Proper organization of this data can link every diagnosis, test, and prescription for each patient in a way that each doctor and patient are unable to do for themselves. The government can make this happen by regulation.

Our President can no longer avoid sharing available and accurate health information that may be in conflict with some special interest groups that supported his campaign. Those involved in health plan administration must no longer withhold vital information about our health even though it may not be in their financial interest to disclose it.

Only with clearly understood reasons for change will change occur, patient physician bonds strengthened and special interests pushed aside. Changing the discussion to a “Moral Imperative” as mentioned today does not give a practical incentive for change that is ultimately determined by the people of America. He has already won consensus on the need for change.

If our President does not get off the ropes quickly and change his strategy to improving health by strengthening the patient/doctor relationship he will get knocked out of the health care arena very much like his predecessors and the opportunity for “Change” regarding health care in America will be lost. The President and the nation risk losing much more than the battle for our nation’s health.

The Health Gadfly

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