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With Obama in Wings, Policy Wonks Make Health Wishlists
Posted by Sarah Rubenstein
Barack Obama will be sworn in here on Tuesday, before jumping right on health reform. With Barack Obama’s inauguration just days away, policy wonks are itching to get started on an overhaul of the U.S. health-care system. To mark the occasion, the eggheads over at Health Affairs put out a package of perspective pieces on just what should (and shouldn’t) happen.
We downed a cup of coffee and dove in. Highlights from two of the pieces are below. The whole package can be found here.
Change the way doctors and hospitals get paid. Providing health insurance to everybody is a laudable goal, but it won’t work unless we also overhaul the way health care is paid for, write Mayo Clinic CEO Denis Cortese and health-policy colleague Jeffrey Korsmo. “Because our reimbursement system rewards piecework — performing diagnostic tests and procedures — it’s natural that our health care is laden with these expensive, fragmented piece of care.”
A universal-health program that expands this payment approach would only make matters worse. And without help for primary-care docs, there might not be enough of them to meet demand from people who are seeking care with their newfound coverage. (Try to see a PCP in Massachusetts, for example.)
Payment alternatives might be to pony up more cash for docs who demonstrate better outcomes and lower costs over the span of care. Another approach would be separate payments for those who coordinate chronic care, among the most costly types out there.
Don’t overreach. Let’s keep in mind that the U.S. health-care system is projected to cost about $2.5 trillion this year. That’s about the same as the GDP of France. “It’s not typical of democracies to transform something the size of all of France through a single piece of legislation, or even through multiple laws during a single presidency,” writes Henry Aaron of the Brookings Institution. Plus, the system is majorly disorganized and we can’t anticipate what all the consequences of a dramatic change to it would be.
But there are narrower changes that can be made. For one, improving health information technology won’t cut costs in the short run, but without better IT, “it will prove difficult or impossible to improve the quality of care or eventually to slow the growth of health spending.” Aaron also likes Obama’s idea of a national exchange for people to obtain health coverage. If efforts to provide national universal care don’t work out, he also thinks the federal government should provide money to states that expand coverage. [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-18 17:12
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