To the Editor:
We spend more than 17percent of our GDP on health care and this is projected to increase 6-7 percent annually. Yet the World Health Organization (WHO) ranks in the U.S. 37th among its members. The UK spends 6 percent GDP on health care and was ranked 18th. Add to this, countries that have a mandate or universal coverage are ranked higher and spend much less on health care.
Who uses five indicators to measure health systems?
- Infant mortality
- Health inequality
- Patient satisfaction
- How well the systems serves it members
- Distribution of the financial burden within the population.
The fact is, we use almost 20 percent of our GDP inefficiently. It also is a burden on the other 80 percent.
Should the health care system not think that the system not associated with it would not demand change? The ACA is an instrument for change. When fully instituted the goal is to move health care into a new age of technology.
The America Recovery and Reinvestment Acts (AR and RA) provide high tech Federal stimulus dollars started in 2011 to health care providers who implemented electronic medical records (EMR).
Physicians who met requirements by 2012 can realize $44,000 per physician. This is considered short term investment to save long term. New delivery systems are suggested which will move health care from solo to active engaged practices.
These are integrated delivery system (IDS), employer accountable care organization (EACO), accountable care organization (ACO) medical home (MH), high risk medical homes, and exchanges.
Health information technology (HIT) will revolutionize health and health care delivery. Health information will be protected yet available across the system. HIT will provide prevention and management tools, giving providers and patients' information to care for chronic disease. HIT will coordinate work flow and improve case management of high risk patients. It will enhance communication among multi-specialties, primary care providers and the health care team.
Providers will be paid for keeping patients well. Patients will be rewarded if they live healthier life styles and stay well. Medical education technology information (METI) will develop advanced health care learning, including human patient simulation and training center.
The Institute of Functional Medicine (IFM) provides education to providers and teachers, teaching 21st Century methods. Providers will gain access to knowledge and health information more rapidly and across a wider spectrum. We will spend less on chronic disease management, there will be fewer premature births, end of life treatment will be better managed, non-compliance and ineffective treatment will be less. We will pay providers for quality not quantity, prevention, not just treatment, with reward for performance. There will be acceleration in change from institution to home care. Telehealth will facilitate monitoring patients and mobile health devices will enhance the home care market.
The Medicaid studies done by the state of Massachusetts are in and proves the advantages to integrating Medicaid and CHIPS across all venues. The ACA will bring about increased access, improve quality and save money. It will help stabilize growth of the Medicare Trust. There is also help with long term care in the ACA. There will be changes in health care and how it is delivered no matter what happens with the ACA.
I think we should be able to see it work as intended. As a senior and a Medicare recipient, we cannot afford to start over. There are many that have no other means of insuring access and payment for care.
Lewis Robinson, M.D.