Healthcare Reform Effort Transferred to Intensive Care


I came across a good article  on NPR.com that describes what has gone wrong so far with the healthcare reform effort. Arguably, one could say that the backlash culminated in the election of Scott Brown; a Republican who will now succeed Ted Kennedy and represent Massachusetts in the U.S. Senate.

The long and short of it is this:  healthcare reform is a topic so complex,  that even folks that have spent years within the sector have difficulty grasping all of it.  Another problem is that the various elements of the sector (hosptials, insurers, device companies, providers etc.) do not all have interests which are aligned.   So cost reductions for some,  result in income and coverage loss for others.  Covering those without insurance is a laudable goal, but it should be clear that expanded coverage will definitely increase costs in the short term.    So after expanding coverage, something must be done to contain the cost growth. 

As Charles Krauthammer pointed out in April, “In the end, the spinach must be served.” 

For now, the reform effort clearly is in Intensive Care.  It’s not dead, but it is at risk.  Perhaps at this point, some real bipartisan effort can take place to salvage the endeavor.  From a policy standpoint, it is almost always to pass something rather than nothing, and then improve it around the edges as time goes on.  If nothing is passed, this issue will be toxic to handle in the future.   It wasn’t touched from 1994-2009.  Now, it will be 2010 until [?]. 

Offering real reform of the tort system would be one thing most physicians would like to see.  Under the current wording, state efforts to reform their tort systems would result in penalties, which clearly will discourage this from happening.  It does seem that the tort system is the one stakeholder which was left untouched under the current bills, although insurers, pharma, and hospitals all were asked to make concessions.  Realistically, a challenge to the medical malpractice system at this point in the game is unlikely, but should be explored if it is needed to get a bill passed. 

From the provider standpoint, regardless if  anything passes, the story remains the same;  the gradual slow squeeze of the private practice model will continue.  So for now all eyes are on the ICU, and its star patient.

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