August 12th, 2009 - More on Health Reform

Ever since I came back from the health care forum recently held in Shaker Heights, I have been wishing the momentum begun there would continue and that leadership would step up and work together. Well, obviously that is not the case. We are losing sight of why change is necessary and confusing the general public. Right now, we are witnessing democracy at its worst. We need out leaders to rise to the occasion and stop making this a win/ lose situation. What is missing?

Those of us in health care leadership need to remind our patients and their families what is really broken in the system. We need to explain that the system we have in place now is unsustainable. We need straight talk. As more “Baby Boomers” enter and lose health insurance (from their employers), we are finding that: 1) the current system, if not improved, will implode in about six years, 2) the ranks of the ever-increasing number of unemployed people is exacerbating the situation even more, and 3) doing nothing is not an option.
The government is tackling this mess with the same old political process, with likely the same old political results: someone will win or lose based on votes -- or worse yet, we will get a compromise. Merely tinkering with the system is the worst thing we can do. In this case the end doesn’t justify the means and how we get to where we need be is vital. We didn’t get to the moon or develop the means to perform transplant surgeries through political processes. Where are the best and brightest who understand our health care system and why aren’t they working together under the direction of the current leadership? This issue is too important for all Americans for this overhaul to fail because of stereotypical politicking. And there is a huge difference between keeping a political promise and doing the right thing.

We in health care are forced to ration our services every day in one form or another. We over-utilize in some respects, in order to protect our selves from lawsuits. We compete with each other to make the claim of “full service.” The way we receive monetary reimbursement (which allows us to be able to afford to function) often relates more to negotiation skills rather the basis of our true costs as a health care provider. The public can’t decisions on what is best (even from a price standpoint) because of an unseen “middle man” who negotiates on their behalf. They are not allowed to know rates for health care services in advance of receiving them. They learn their out-of-pocket expenses after the fact. How do the insurance companies really help manage care? Let’s face it, everybody wants the health care we are capable of delivering. It’s just that, more and more over time and due to this broken system, we just can’t afford to offer it. So where is there value added? Where is the waste? With all these supposed and proposed changes, will we have an affordable system? If not, do we redefine the old economic question: “Do we produce more guns or butter?” or to put it another way: “Do we produce health care the same old way or not save our economy and our future?” Sadly, that is our choice at the moment.