Jul 05

ObamaCare: Ready for the Next Stage

by Wayne W. Oliver – Healthcare Consultant
Originally published in the Atlanta Journal Constitution on July 4, 2012

The fate of ObamaCare now moves from the legal and constitutional stage back to the political arena.  As most Americans know by now, Chief Justice John Roberts joined with the more liberal members of the Supreme Court of the United States to create a 5-4 decision upholding ObamaCare as constitutional based on the ability of Congress to levy taxes. The high court has finally ruled on ObamaCare. So, what does this all mean?

Well, it might not be the decision most conservatives would have liked, but at least it is settled … for right now. Many health policy experts and political pundits are saying that the Chief Justice had a mental lapse or that he was pressured by the liberal media into upholding ObamaCare.

So how can the Chief Justice justify his historic position on the president’s signature legislative achievement?

First, he doesn’t have to … as it is all laid out in the opinion. The Chief Justice wrote in the majority opinion that ObamaCare was unconstitutional based on the Commerce Clause but was constitutional since Congress has the authority to create taxes … or impose penalties as they are described in ObamaCare. Secondly, Chief Justice Roberts may have ultimately decided that the American people … not nine black-robed presidential appointees … should decide the fate of ObamaCare.

And the Court’s decision could not have set up a more perfect storm for the November elections. One candidate likes all 2,700 pages and the other wants to repeal it. So the choice is pretty clear.

But before we all rush out to expand Medicaid programs … and before we set up elaborate health benefit exchanges with state or federal bureaucrats deciding what American families get in their health insurance policies, let’s remember that American healthcare system is still fundamentally broken. And, ObamaCare does little to fix it.

And, to me, we should focus on fixing the system before we expand coverage to 30 million new individuals.

Our current system rewards transactions instead of results. And, ObamaCare doesn’t change that. Doctors, hospitals, and pharmacists get paid when patients access the system. Every time a healthcare provider interacts with a patient, a transaction occurs and a charge is generated.  Payment is based on the number of transactions a healthcare professional provides rather than being based on a specific health outcome.

Instead, we should move to a system where the doctor, hospital and pharmacist are motivated to help the patient stay well. We should provide incentives for physicians to keep patients healthy. We should reward pharmacists when patients take their medications properly and adhere to their medication regimen. We should provide incentives for patients to become active and actively engaged in their own healthcare. In my opinion, rewards and incentives work better than penalties … or taxes … in this case, as determined by the Chief Justice.

Our current system is healthcare provider centric.  In other words, the doctor, the pharmacist, the hospital or the rehab therapist are central to the transaction of healthcare services.

Instead, we should migrate to a healthcare system where the patient is at the center of care and healthcare providers work in concert with each other to maximize patient-centered health outcomes and deliver the best patient care experience.

Our current healthcare system is way too expensive and ObamaCare does nothing to lower the cost of healthcare in America. Healthcare professionals … specifically physicians … spend too much time and too many resources on reducing their exposure to potential lawsuits instead of focusing on helping the patient get or stay well.  Hospitals and doctors order way too many tests … way too many procedures … and way too many powerful medications … not to help treat a disease or to help develop the proper diagnosis but rather to avoid a frivolous lawsuit brought by a personal injury attorney who advertises on late night TV.

Instead we should insulate providers from unnecessary litigation when they follow the legitimate standard of care and most current clinical best practices. I have written in this space about creating a new system of health justice (“Let’s Get Serious About Healthcare Costs,” February 3, 2012) … one that creates a new model for compensating legitimate medical errors. By creating a new system, we would not only improve the quality of care provided to patients by reinforcing best medical and clinical practices, it would also eliminate a ton of excessive and inappropriate testing and procedure and reduce overall healthcare costs.

So ObamaCare is left up to the American people in an election year. But before anything happens, we should fix the current system now … before we expand coverage to millions of Americans. Otherwise, we will be simply be wasting time and resources on a bigger but not better healthcare system.

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