Sunday, October 14, 2007

A Talk on Reform and Innovation: Your Advice Please

I need your advice. I seek your take on what basic things you think it will take to transform the American health system to make it more patient and doctor friendly.

Why do I ask? Well, I’ve spent the last two days preparing a talk before an audience of entrepreneurs, information technologists, venture capitalists, hospital executives, business leaders, movers, shakers, and physician innovators at a leading eastern academic center.

My title is “The Rise of Innovation: Socioeconomic Schisms, Sophisticated Algorithms, and Marketing Rhythms.” Those who invited me to speak asked I address the doctor’s point of view on the role of innovation in health reform.

What can I say that hasn’t been said? On reform, some physicians believe in a political utopia – generous government programs covering the uninsured. Other more market-oriented doctors believe the uninsured problem has its roots in government overregulation, managed care micromanagement, and high premium costs. Many of the uninsured are young and healthy don’t think non-deductible premiums are worth it; other lower income folks simply can’t afford it.

I think the final reform measures will be a mixed bag, with equal elements of government and innovative market reform. What’s your belief?

4 comments:

LISA EMRICH said...

You've probably heard much of the same before. For the perspective of one patient who struggles with the reality of healthcare costs and the theft of a brighter financial future, I invite you to read some of these articles.

Calvacade of Risk is Up and my post regarding Questor is included!

What Questcor didn't tell you about their income losses...

Questcor uses Orphan Drug Act as a strategy tool to boost marketing and development

Dear ABC, 20/20, and John Stossel...

Entrepreneurs and Revolutionists

That should provide enough 'food for thought.'
Thanks

Weschtester Orthopedist said...

I must say that I clearly fall into your market oriented group.

I believe a multi-tiered system will arise from the rubble. The highest level will be for those who can afford and more importantly, those who want to afford it. They will have access to the most expensive (and potentially unproven) medications, technology and services. There will be a level below that which most employers will offer, but it will limit expenses on meds (Walmart's $4 list) and potentially limit access to "experimental" technologies and services. Somehow the patient will need to share the financial burden of some of their choices eg. MRI for knee pain, etc. But I do not beleive that chronic disease care, or emergency care should be tied to their deductible. You shouldn't be afraid to go to the ER with chest pain because of a deductible.

Ultimately there has to be a safety net program in place. This will assure that the 50 or so million americans who worry about their next illness and the "theft of a brighter financial future" has access to medically necessary care. Unlike Mcaid, even the safety net system will need to be a co-pay based system (even if it is only $5) to prevent some of the abuses that occur with Mcaid.

I strongly believe that the market should be allowed to drive the system. Meaningful, transparent and independent quality and outcome measures must be available to everyone.

Medical errors must be addressed by having a nationwide EMR/PHR system that will monitor for drug interactions, allergies and perhaps disease management too.


Not sure I helped...just my thoughts.

Richard L. Reece, MD said...

I appreciate your point of view. I know many many consider health care ought to be government-granted right. The downside of that view. according to critics, is mediocre care, loss of access to the latest medical advances, limited freedom and choice, long lines, and rationing. With our current system, we already have covert rationing: with a government system, rationing will simply be more overt.

To my orthopedic friend:

I suspect you're right - a multitiered system will arise out of the rubble, and we'll need a government safety net.

Richard L. Reece, MD said...

I appreciate your point of view. I know many many consider health care ought to be government-granted right. The downside of that view. according to critics, is mediocre care, loss of access to the latest medical advances, limited freedom and choice, long lines, and rationing. With our current system, we already have covert rationing: with a government system, rationing will simply be more overt.

To my orthopedic friend:

I suspect you're right - a multitiered system will arise out of the rubble, and we'll need a government safety net.