Stanley Feld M.D.,FACP,MACE
Congress is not focused on the main problems in the healthcare debate. It is focused on the vested interests of secondary stakeholders. The people with the most money always win.
It is time for the people to speak out for their vested interests. They are trying via the Tea Party. For some reason the media is threatened by the Tea Party. The media has tried to marginalize the Tea Party. I do not think the media will be successful.
The American healthcare system has many problems. Accountability for medical care is one of them.
Millions of dollars have been spent by hospital systems trying to form an Accountable Care Organization. Why? Everyone thinks that is where the money is going to be. Accountable Care Organizations will not be the answer.
Effective repair of the healthcare system can only be accomplished when all the stakeholders are accountable for their part in the delivery of medical care. Those stakeholders include patients, physicians, government, healthcare insurance companies, and hospitals.
Accountable Care Organizations hold physicians and hospitals accountable for making patients healthy. Patients are the stakeholders who must be accountable for their own healt care. Patients are the only stakeholder that can force the other stakeholders to be accountable for their part in the healthcare system.
Accountable Care Organizations (ACOs) are in reality a rehashed version of the failed HMO model of the 1980s. The government must reduce the cost of healthcare. It would like to eliminate waste in the system. Electronic medical records will help except the government is wasting money trying to implement the electronic medical record. It will fail using the present implementation system.
The government’s thinking is Accountable Care Organizations will integrate the healthcare delivery system and eliminate waste. The government would rather deal with one organization rather than individual physicians. The government will give millions of dollars to private hospital systems. The hospital systems will hire physicians. It will then call itself an integrated system. The integrated system will be rewarded financially when it keeps patients well.
Ignored is the fact that the distribution of funds will be a source of bitterness between physicians and hospital systems. Hospital systems are going to own physicians skills and intellectual property. Physicians are becoming wise to the scheme. This conflict will create waste and increase costs to the healthcare system.
Once the federal dollars dry up, these entities will fail under the weight of their own bureaucracy. Patients are now being given a free ride at the taxpayers’ expense. They will develop an insatiable demand for free medical care. The administrators of these failed entities will stash away their generous salaries and add no value to the delivery of medical care. This is what happened with HMO’s. The public and physicians have not forgotten this experience.
Medicaid is a failed model. Yet 16 million more people will be added to its role under President Obama’s healthcare reform act and be taken care of by ACOs.
We will create a larger underclass of people dependent on the failed Medicaid system. Rather than being a nation of hard working independent people responsible for their own well-being, America is increasingly becoming a nation of people expecting hand outs the national budget cannot afford.
The purpose of an effective healthcare system is to keep our citizens healthy. You accomplish this by promoting the principles of good health and giving incentives to citizens to be responsible for their health and healthcare. It will not be accomplished by making people dependent on the government and its inefficient bureaucratic structure.
America must develop a healthcare system that:
1. Provides education about maintaining good health and early recognition of disease.
2. Diagnoses disease early with efficient testing.
3. Develops a treatment strategy that educates patients to participate in their care.
4. Encourages good health and healthcare choices to minimize the need for more health care.
This can be accomplished in a consumer driven healthcare system using the ideal medical savings account. It will be less costly and more efficient than the complicated structure President Obama’s healthcare reform act is in the process of creating through Accountable Care Organizations.