Health care reform is underway in many countries around the world. This is partly a reflection of the fact that people are losing faith in their old agenda for quality, and are at a turning point that makes it possible to take another approach.
Health system reforms should aim to control rising costs and realign how quality, as a return on the healthcare dollar spent, is measured. To do so, they must implement a variety of payment reform models that change the incentives facing providers and patients.
For example, the current system rewards medical interventions like surgical procedures and prescription drug refills (which increase revenues for hospitals and pharmacies) while ignoring other activities that may have similar patient-benefiting outcomes but lower costs (such as encouraging a person to modify their diet or quit smoking, or following up with prescribed regimes). This imbalance also promotes perverse behavior such as sloppy hospital discharge practices and excessive readmission rates.
Other reforms include the ability for Americans to buy a Medicare-like plan if they don’t qualify for regular Medicare coverage, closing the “donut hole” in Medicare Part D prescription drug coverage and making it easier to get preventive services, such as immunizations and cancer screenings. These changes will help reduce the burden on family budgets, while saving money for the health system and improving the quality of care.
To realize these benefits, reforms must be implemented quickly and based on principles that are consistent with the existing safety net. They must also allow individuals to stay on their employer-sponsored or ACA marketplace insurance plans during the public health emergency and provide additional help for those without access to affordable health insurance. Finally, it is important to develop an objective method of measuring whether a given health reform or improvement has actually resulted in sustained, positive impacts. This can be done by comparing the results of the intervention to an arm’s-length group that does not receive it.
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