Health care reform is flawed
December 2, 2009
The three-legged stool of health care is high-quality care, good access to care and affordable costs. The old joke in health care was pick any two, because three is not realistic. Unfortunately, both congressional proposals only give you one of the three – access. Both proposals promise to improve access, but quality will decline, and costs will skyrocket.
The facts are clear. Medicare and Medicaid are going broke, and more providers are not accepting new patients with this entitlement. Many physicians do not accept Medicaid because the reimbursement is so low it does not cover the cost of providing the care. So in some respects, access to care may be limited if Medicare and Medicaid are expanded or a public option is included.
How about Sen. Joe Lieberman’s comments on fiscal risk: “Once the government creates an insurance company or plan, the government or the taxpayers are liable for any deficit that government plan runs, really without limit. With our debt heading over $21 trillion within the next 10 years … we’ve got to start saying no to some things like this.”
The House bill creates 111 new government agencies/programs with staff, facilities and budgets that will pull money away from direct health care and create a bloated, costly bureaucracy. The bureaucracy will not see patients, cure diseases or improve quality of care. Instead government waste will make insurance company overhead look like a bargain. Every government mandate on health care providers costs money and is shifted into the cost of care, so you end up paying twice – once for the bureaucracy and second for the cost of the mandates.
Many doctors and hospitals with high Medicare/Medicaid populations take the following steps: a) limit time with patients; b) limit appointment availability (less access); and c) shift to nurses, nurse practitioners and physicians assistants providing the vast majority of the care. I don’t define quality care as less time, less availability and less medical credentials. Do you?
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Finally, passing a flawed bill is not a victory. Nor is it victory to stubbornly oppose any form of reform to a system that needs improvement. We deserve better from those we have elected to represent us.
fellow, American College of Healthcare Executives