Tipping health care in the right direction
Recently billionaires Jeff Bezos of Amazon, Jamie Dimon of JPMorgan Chase bank, and Warren Buffett of Berkshire Hathaway announced plans to tackle health care. As expected from three titans of industry, this move makes sense because health care is big business, gobbling up 17 percent of the U.S. economy and rising.
Because health care is a mess, as anyone who has confronted the disjointed maze of doctors and hospitals and the thicket of copays, deductibles, and mind-numblingly expensive bills that follow can attest. Despite this current disarray, their timing is also impeccable, because health care is on the brink of becoming more efficient and effective.
Increased efficiency will lead to either huge profits for a few, or the opportunity to provide everyone access to basic health care services.
Health care is at a tipping point. Positive changes will be driven by three trends:
▪ the digital revolution that will finally sweep through health care
▪ the growth of accountable care organizations (ACOs) responsible for the entirety of their patients’ care
▪ team-based approaches to care
Health care has been late to join the digital world. It was only a decade ago that medicine was notorious for illegible physician writing, and electronic medical records still don’t communicate with each other.
Use of personal devices to text, call, email, send images, or video conference is commonplace in other fields, but is exasperatingly rare and difficult in medicine.
Health care also suffers from a lack of coordination and cohesiveness.
The growth of ACOs, groups paid to manage patients efficiently and effectively, will drive alignment of our health care delivery system by:
▪ facilitating communication both among providers and with patients using e-technologies,
▪ building on a foundation of primary care
▪ support team-based approaches to care
▪ adjusting the way hospitals and clinicians are paid
▪ supporting transitions of care
These trends will also spur investment in public health, community partnerships and more.
Everyone should expect to receive high quality health care. The Institute of Medicine defines quality as care that is efficient, effective and equitable, as well as patient-centered, timely, and safe. Health care will make improvements,, but we need strong advocacy and leadership to make sure it is equitable.
The clearest path to an equitable health care system is to provide everyone access to basic health care services by expanding Medicare to all Americans.
Access to basic health care does not need to be a Democrat or Republican issue. Government programs including Medicaid, Medicare and Veterans Affairs already account for over half of all health care coverage, and dissatisfaction with insurance options clear.
There are also compelling medical reasons for supporting Medicare for all.
Consider the patient who has a stroke. The most important risk factor for strokes is high blood pressure, which is also called, “The Silent Killer,” because you may not have any symptoms when your blood pressure is high.
People who don’t have health insurance are less likely to have preventive screenings including blood pressure checks, or to purchase the medications that can keep their blood pressure under control. It is much healthier and less expensive to control blood pressure and avoid the devastation of a stroke.
We don’t let people die on the street, and we don’t let emergency rooms turn away sick patients. Someone pays for their care.
Health insurance, copaysand deductibles should not be barriers to accessing care. Unnecessary utilization of high-cost services can be controlled by providing seamless access to the right care at the right time.
These are turbulent times, but a brighter future is much closer and more attainable than we might think. To tip health care away from profits for a few, we must advocate for, and elect politicians who will support Medicare for all.
Dr. John Zweifler of Fresno is regional medical director for the Adventist Health Plan. Connect with him at zweiflja@ah.org.
This story was originally published April 5, 2018 at 7:35 AM with the headline "Tipping health care in the right direction."