Where do reasonable healthcare costs end and outrageous ones begin?
Time magazine and many other publications have been reporting the shocking numbers individuals are paying for their healthcare. The Affordable Care Act addresses those ever-increasing figures through the Triple Aim:
1) Improve the culture of healthcare
2) Improve the quality of healthcare
3) Decrease the costs of healthcare
I am not arguing whether or not the ACA can accomplish these goals; however, I agree that the cost of healthcare is unsettling when compared to other industrialized nations across the world.
Presently, we are paying close to 18% of our GDP for healthcare and it’s broken. Additionally, it is paralyzing businesses and threatening personal household incomes significantly.
When you look at countries like Denmark, whose population is very satisfied with their available healthcare and only paying 5% of their GDP toward it, you realize something definitely needs to change.
How did we get into this trouble?
I think “fee for service” has been a major offender. The government gives a blank check to the healthcare system to perform an unlimited amount of medical activities. In other words, the healthcare community can look to find sickness and get paid, as much or as little, as they want for trying to fix it based off of how many medical activities they perform.
This reminds me of an article that was published by the NY Times in 2009. Dr. Paul Grundy, the former Medical Director of International Business Machines, Corp. (IBM) shared that IBM paid $1.4 billion in 2008 for garbage. He was referring to the fact that we pay for sickness, rather than health.
After many years of operating this way, our culture has been trained to accept this standard. It is extremely important to understand that the ACA is striving to bring cost control to healthcare, while simultaneously improving the quality of healthcare.
The ACA did not break healthcare as this NY Times article argues. The question we need to be asking is if the ACA can help fix our already broken healthcare system or create more problems?
Through payment reform, we will be noticing a change from the “fee for service” payment system to a “bundled” payment system.
Rather, the government will establish an amount they will pay for specific medical activities. Healthcare professionals will make every effort to provide their very best care below these set amounts.
This holds healthcare professionals accountable for the care that they are providing patients and mutually invests all parties in the healthcare delivery process because everyone’s goal is health, not sickness, which our culture has come to accept.
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