Thursday, July 16, 2009

Making more insurance available does not make more and higher quality care available

Congress and our President mean well and have correctly brought to the front of all discussions that health is one of our nation’s highest security risks, yet the newest of plans put forward continue to replicate failed efforts of the past.

CNN today reports the sobering takeaway from testimony Thursday by Congressional Budget Office Director Douglas Elmendorf and states “The health reform bills released so far would increase government spending on health care without sufficiently reining in health care costs.”

Fortunately our government structure is so good that people like Elmendorf can be heard.

Health policy analysts support two ways to "bend the curve" on health care costs above others, Elmendorf said.

--Change how employer-paid premiums for workers are treated -- currently they're tax-free to the worker.

--Change how Medicare pays providers to reward cost efficiency and quality of outcome rather than the a la carte approach of fees for service.

The last bullet is half of the key to the kingdom of higher quality and affordable health care for all. The other half is an incentive structure that unites physicians with their patients. Providers are unable and ill equipped to accomplish this task without a unified effort with their patients stimulated by the appropriate incentives from the federal government.

The change required is to pass laws that align incentives for individuals, their health care givers, and the payers. This means an end to health insurance as we have known it. The issue for congress and the president is how to improve health. The issue is not coverage, it is access to care! Access to care is available to all but a few million uninsured Americans, yet appropriate care is not obtained among all of the millions who have insurance.

Making more insurance available does not make more and higher quality care available.

The Health Gadfly