Considering that reimbursement has been based on volume/fee for service, the question that must be asked of our readers is how easily will it be to transition the system to one that is structured on successful outcomes or value based medicine? To align the the incentives of doctors, nurses, pharmaceutical companies and hospitals through value-based purchasing is easier said than done. So, in the spirit of debate, who is qualified and will establish the standard for a job well done? Who will come up with the criteria to measure outcomes, and how will that measurement take into account those physicians that treat patients that need medical attention but have associated medical problems? What type of metric will there be to evaluate fusion rates when the patient smokes, is an alcoholic, is obese, or is involved in substance abuse? What happens if the patient has been in a high-speed MVA, will the surgeon and hospital be penalized for having to stage the patients modality of treatment? Unfortunately, those that legislate on behalf of their constituents do not understand that sometimes this is rocket science, even if the individual claiming that medicine is not rocket science, is a former surgeon himself.
So how do we reduce cost, whereas we avoid higher taxes? Why is it that the government and the ABA have such a difficulty in enacting tort reform? If we are a people that believe in free-markets, then why can't we cross state lines to buy better or cheaper insurance? How does the industry delivery better technology, better care, and better outcomes at a cheaper cost? If the best that both parties have to offer is placing the onus on providers to prevent and manage illnesses while reducing complications and cost in the hope of providing data to measure patient outcomes shows how little politicians understand the complexities of modern medicine.
Do any of our readers find it disturbing that the focus of the debate and the onus of providing value based medicine is always on the provider and the patient? What about the escalating cost of healthcare insurance, witnessed by what was reported over the weekend from California regarding Anthem Blue Cross' increase of 25-39% for private subscribers? If the insurance industry is a risk-management business, why aren't people rewarded that have never had to use their health-care plans outside of going for an annual physical? For politicians to pontificate about not appointing Kafkaesque committees to measure quality adjusted life years but foster a climate of scientific research and pipelines for new modalities of treatment exhibits how little they understand about the complex cost of medicine.
Before the cost of healthcare is ever contained, the American public, which includes politicians will have to re-align their priorities not only from a personal health perspective but also from a financial perspective. This will mean not being influenced by every lobbyist that roams the hallowed halls of the Capitol Building. If the two most important aspects of this bill will be to reduce cost and provide coverage for more people, let's clean the slate and start with the insurance companies and address how we will pay for those that have no coverage, and who will take care of those that have minimum coverage? Unless the government continues to print money or raises taxes, how will we subsidize the uninsured? If government officials or think- tank gnomes don't believe that we pay attention to the rising cost of healthcare insurance, then they themselves are living in neverland.
The time has come that both parties start acting in the peoples interest, and not in their own interest, and that means placing America first. If the government was willing to bail out the "banksters" or gangsters of Wall Street, why do we Americans find it so difficult to bail out the uninsured? Why do we dump billions of dollars into Middle Eastern countries that could care less about democracy or human rights, while at the same time mortgage our children's future? It's an embarrassment when we call ourselves the richest country in the world, worry about everyone else's problems, yet have an inability to take care of our own challenges. The answer is simple, it's GREED and SELFISHNESS.
So there you have it readers, let's see what your perspective is on this issue. Take the time and think this through because your opinion and most importantly your vote is the only thing that will change healthcare, its time to get the politicians out of office that are not interested in finding a viable solution to an complex problem.