Roadmap for Health Care Reform - Part 1

A transparent roadmap is needed looking out 10 to 15 years, to see the implications of the changes that proposed health care legislation would make incrementally over time and to give us a picture of that which government cannot supply. Looking at these assumptions and testing what other changes may occur in the future would give us confidence that we are creating a unique solution for the United States with our values of freedom and personal autonomy, and not just a path to socialized medicine. Without this roadmap, the political process cannot effectively broker a solution based on confidence from the voters that vested interests have not taken over. The interests of large global corporations have much in common with a socialized approach to medicine and much be counterbalanced by local interests and well informed voters. We need to have a sense of the endpoint 15 years from now, based on what will happen to government budgets and economic/medical technology scenarios.

As I mentioned in previous posts, there are several conditions to be met to maintain a hybrid public/private health care system that provides necessary services at a reasonable cost and maximum value for outcomes, and optional services on a competitive basis. First of these is that the payer system of public and private insurance needs to be carefully balanced so that the subsidized public programs do not crowd out private industry. The private insurance industry also must change to be more than a financial instrument in order to add value to the health care system. Second, for the rapid implementation of interoperable information technology throughout the health care system, a common format and process implementation for electronic medical records and information exchange will be needed. But to preserve privacy and individual freedoms these records must be owned and controlled by the individual citizen. Third, preservation of real choice in the system for selection of doctors, treatments, institutions, and methods of financing requires decision making at the local level and funding of new care delivery models, even though there can be regional exchanges of information and replication of model health care delivery, information technology, and financing systems.