For almost two years, Americans have lived in limbo — not knowing if the 2,770-page health reform law would forever change how we conduct the business of health care.
This week, we found out that an answer is not far away.
The U.S. Supreme Court has agreed to hear the legal challenge to President Barack Obama’s signature health care law, drafted with little public input, that created 159 new agencies, offices and programs and granted a litany of unchecked powers to a few Washington bureaucrats, most notably, the Commissioner of Health and Human Services.
The nine members of the nation’s highest court will not only decide whether it is constitutional for the federal government to mandate that Americans purchase health insurance, but also whether the federal government can force states to expand their enrollment in Medicaid.
The legal arguments to be heard next spring will be the Super Bowl of Supreme Court cases, and the court’s ruling will be one of the most heavily anticipated outcomes in years.
It should have a profound effect on the 2012 presidential election as well as the health care industry, which represents more than one-fifth of the entire American economy.
But no matter the outcome, we at the Center for Health Transformation will continue to advocate for a 21st-century model of health reform.
We believe there is a need to put in place legislation that focuses on a patient-centered model that lowers costs while improving health outcomes.
Successful health reform must not be a top-down federal approach, but one that allows states and individuals to devise health care models that work for them.
Among a few of the principles we would encourage Congress to consider:
● Bold movement away from the traditional fee-for-service delivery model toward an outcome-based payment system. We must make payments to providers based on positive patient outcomes. A 21st-century model encourages patients to be engaged in their own health care and creates incentives for doctors and hospitals when patients get well, and less when patients keep returning to hospitals in a revolving-door fashion. ● Advancing consumer-directed health care. To empower patients with their own health care, we should overhaul the tax code to encourage more Americans to set up health savings accounts. HSAs would allow consumers to pay for routine medical care, and then utilize high-deductible insurance plans for major medical expenses. However, the new health reform law unfortunately taxed and restricted health-savings accounts, dealing a blow to consumer-driven health care. ● Aggressively fight criminal activity within Medicare and Medicaid and beef up fraud-prevention programs. Some crooks claim it is more profitable to cheat the government in these programs than to deal drugs. The inspector general believes nearly 10 percent of Medicare cases are fraudulent. Hundreds of billions of dollars could be saved through better enforcement, whether rooting out nursing homes billing the government for deceased patients or criminals running HIV clinics at the back of pizza parlors. ● Encourage states to enact civil justice reform to prevent frivolous lawsuits that drive up health care costs. A Jackson Health care/Gallup physicians’ poll last year found that one in four dollars spent on health care is dedicated to unnecessary tests, procedures and drugs that doctors order to prevent being sued. As long as doctors play defense, costs will continue to escalate. ● Create additional federal incentives to ensure nationwide implementation of electronic health records. An electronic platform reduces the chance for medical errors and makes it more efficient to transfer a patient’s history from one provider to another.
These are a few ways that we can incorporate solutions, put patients at the center of health innovation and achieve the goal of saving lives while saving money.
Nancy Desmond is chairwoman and CEO of the Center for Health Transformation, founded by former House Speaker Newt Gingrich. Vincent Frakes is the federal policy director for the Center.
About the Author
