So, it passed. Now what?

March 22nd, 2010 by Nick Jacobs Leave a reply »

The very essence of the fabric of our society has changed today and forever.  The questions that arise from the passage of health care  reform are endless in number and the answers will be both evolutionary and revolutionary.  Not unlike those dark or bright days following the passage of Medicare back in the 60’s, the naysayers are predicting the end of the United States and those individuals who will be positively impacted are finally able to sleep through the night without feeling the steady stream of their own tears flowing across their cheeks because they either couldn’t get care or couldn’t afford to pay for the care.

It is more than a cultural change, it is a humanity change.  The key to both, however, is the word change. Those who have wonderful, sustainable, well-financed lives with adequate health insurance are concerned that their hard-earned dollars will go to support an inefficient welfare sate.  Interestingly, many of these people clearly may benefit tremendously by these changes, but  they are unsure as to what that change will represent to them personally.

When Medicare passed, those who did not or could not embrace it quickly enough did have significant life changes.  On the other hand, those who could ended up doing better than they could have ever dreamed.  The same was true of the managed care movement of a dozen years ago. The real question here seems to be one of  “The Greater Good.”  Will it be worth it to help our fellow man?

The bigger issue in my mind is the question of our ability to shift from sickness to wellness care. Wellness and prevention, Tort Reform, Big Insurance, Big Pharma, were all part of the dance.  What will their involvement be in this new healthcare plan?  My insurance friends are predicting the end of their world. Will it be the end or just a different model?

What do we need to do to make it work?  We need to end two wars, decrease the DoD spending accordingly, and monitor those who abuse the system.  We still need Tort Reform. We need to reimburse our physicians for counseling their patients about wellness and prevention as well as for end of  life choices and options.

Telemedicine technology

In a recent article in the Harvard Business Review by Gardiner Morse, The Ten Innovations that will Transform Medicine, we see a stimulating list of opportunities that could make this all work better:

1. Evidence Based Decision Making
2. Payment Innovation (based on outcomes and volumes)
3.  Patient Portals for access to personal health information
4.  Behaviorial Economics
5.  Protocols that work for specific treatments
6. Accountable Care
7. Regenerative Medicine (incl. adult stem cells)
8. Virtual Visits  (telemedicine)
9.  Genetics
10.  Robotics

Regardless of your personal view of healthcare reform, it was clear that the system has been broken for a very long time, and whatever religion or spiritual belief you embrace, it has to be supportive of an effort that will potentially stop destroying the lives of others due to either a lack of available healthcare or a lack of finances.  Stay Tuned.



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