Sunday, November 22, 2009

An objective look at Health Care Reform

Dr. Jeffrey S. Flier, dean of the Harvard Medical School weighed in this week on health care reform. I haven't seen a less political analysis of the current legislation before Congress, and it's worth your time. It can be found here.

In addition, here are some highlights:
Instead of forthrightly dealing with the fundamental problems, discussion is dominated by rival factions struggling to enact or defeat President Barack Obama's agenda. The rhetoric on both sides is exaggerated and often deceptive. Those of us for whom the central issue is health—not politics—have been left in the lurch. And as controversy heads toward a conclusion in Washington, it appears that the people who favor the legislation are engaged in collective denial.

Our health-care system suffers from problems of cost, access and quality, and needs major reform...

Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that's not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform.

In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system. The system we have now promotes fragmented care and makes it more difficult than it should be to assess outcomes and patient satisfaction. The true costs of health care are disguised, competition based on price and quality are almost impossible, and patients lose their ability to be the ultimate judges of value.

Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.

Put more succinctly if less elegantly, the current legislation will improve access to health care, but will increase cost and decrease quality, and thus only addresses one of the three common problems in our health care system.

Worse yet, currently proposed legislation will end the potential for reform that addresses all three issues of cost, access and quality.

If you haven't already done so, please contact your Senators and Representative and express your feelings on the bill. Phone calls and e-mails are likely not having much impact. I'd suggest a fax or walk-in visit to their offices at this point.

If you don't know how to contact your legislators, you may locate your specific lawmakers and their contact information here. The information for your two senators should be easy to find by state, and they're most important just now as they'll be voting on legislation right after Thanksgiving. You may find it easier to locate your House of Representatives legislator here.

It really doesn't matter which of the many sides you're on in the health care debate. The current legislation is bad for everyone, and it's important to contact your legislators now. Real, innovative solutions exist, and we need to pursue them rather than copying systems that don't work.

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