Overhaul debate was healthy
By Luis Fábregas
Published: Friday, June 29, 2012, 10:20 p.m.
President Obama's health care overhaul may have polarized the nation but it also helped to jumpstart a much-needed debate about the price we pay for medical care.
With the Supreme Court ruling on the Affordable Care Act behind us, we can take a deep breath and agree that much more needs to happen to fix the nation's health care system.
Dr. Steve Shapiro, chief medical and scientific officer at UPMC, put it best when he told me "the greatest challenge for our country, economically, is to lower health care costs."
Indeed, health care expenditures in the United States neared $2.6 trillion in 2010, more than 10 times the $256 billion spent in 1980. The spending has grown faster than the economy as a whole, and we spend far more than most developed countries.
"It puts us at a disadvantage being 50 percent higher than other countries," Shapiro said. "The unsustainable cost is going to drive the change."
The change he's talking about has more to do with how hospitals and doctors deliver care and not necessarily the political hot potato that is coverage for the uninsured. We'll leave that to the politicians. Thankfully, the incessant debate over the health care law has put the spotlight on patients and quality.
As health care executive Diane Frndak of West Penn Allegheny Health System said: "A lot of the spirit of the act is around trying to provide better care at a lower cost."
Sprinkled throughout the act are many provisions that address the need to improve care. Among them are higher-than-expected readmission rates, hospital-acquired infections and medical mistakes.
For more than a year, hospitals have been gearing up to address those issues - regardless of the Supreme Court case outcome.
Shapiro said UPMC's plan to target readmissions among heart failure patients has led to a significant drop in the number of patients who find themselves back in the hospital within five days of discharge. That's mostly because those patients received follow-up care within five days of discharge, which was a very simple solution to a very complicated problem.
UPMC also has embraced other solutions to contain costs, Shapiro said. Doctors and nurses are providing more education about palliative, or end of life, care to patients who face aggressive treatment in their last days.
It's not about denying them treatment, he said - it's about giving them options.
At West Penn Allegheny, leaders told me they are pursuing a philosophy known as patient-centered medical homes, which emerged as a result of the law. The medical home emphasizes a team approach to primary care, headed by a physician who consults with other health professionals. Again, the aim is to cut costs and improve care.
There are countless other ways in which hospitals and doctors are working to improve care. Sure, they've been threatened with fines if they don't meet certain standards.
But the point is that they finally have come to terms with the realization that if we leave the system untouched, it will become undone, and we will pay dearly.
So say what you want about Obamacare, or whatever you want to call it. It's a debate that needs to happen.
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