Viewpoint: Keys to healthcare reform success

March 10, 2012

Why can't America deliver on its reform promise? Identifying and addressing these roadblocks could lead to a financially and socially succesful healthcare program.

ROADBLOCKS NEED TO BE OVERCOME TO ADDRESS PROBLEMS

AGREEMENT NEEDED

Not everyone agrees healthcare reform is necessary. To go forward, America must agree on these fundamental premises:

FEARS ABOUND

Some constituencies fear change and believe their interests lie in maintaining the status quo. For instance, insurance companies and suppliers of medical products and their stockholders fear major changes to the industry and a resulting loss of profits. Hospitals, which increasingly are purchasing physician practices to promote more hospital stays and to control and capture both inpatient and outpatient revenue streams, fear elimination of this scheme.

Lobbyists for special interest groups fear loss of their jobs. Nursing homes, which lack cost control oversight and are not required to accept Medicaid patients, fear regulation of their practices and loss of profits.

People with premium, private insurance policies fear loss of coverage for expensive procedures or higher premiums, and they worry that the choices or quality of their healthcare will decrease. Physicians fear total fee control by government or, worse yet, no latitude in methods of treatment, with no bargaining power or input from them. They also believe that accountable care organizations are, in fact, a variant of the health maintenance organization care model cleverly renamed so as not to frighten the electorate.

Manufacturing companies are not on board with reform because they do not want to incur the costs that they fear universal coverage would shift onto them. They want to remain competitive and, therefore, see healthcare reform increasing their costs and threatening their competitiveness in the global marketplace.