Technology

Food for thought – 9 steps to significantly improving health and healthcare

I spend a lot of time thinking about how health and health care in the US came to the current state.   In thinking through how to categorize the woes of our health and our health care system, I began articulating what it would take to significantly improve our current state.  In order to foster productive debate, I’ve decided to share here what I call my “checklist to cure the health care system’s woes”

1.       get the population to act like health care consumers via transparency on cost and quality and disintermediation of the cost of health insurance [1]

2.       make all patient data patient owned and patient centric via secure patient health record

3.       break the ‘3-foot rule’ so that care can be delivered (and relationships strengthened) beyond the 4 walls of the provider

4.       give the consumer immediate financial skin in the game so that they understand how taking better care of them self will lead to financial savings as well as improved health[2]

5.       ensure all people have access to free (meaning ‘paid for through taxes’) preventative care

6.       ensure all people have access to safety net insurance for catastrophic care

7.       require that all providers of care use an electronic health record and be connected to a health information exchange [3]

8.       remove perverse incentives in the system that encourage duplication of tests or defensive medicine and instead let the system pay the best doctors for the best performance

9.       reduce fraud in the system

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[1] because employers typically act as intermediaries in paying for health insurance, health care consumers for the most part have no visibility into the full cost of health insurance.  It also means that most health care consumers have a limited choice in health insurance providers (since employers typically offer a vastly reduced set of options), and that employees who change jobs also must change insurance providers.  Disintermediation would mean employees would get the full bill for their health insurance (making them aware of the cost).  Employers could still give a voucher or Health Savings Account contribution to the employee to offset the cost of insurance.  Disintermediation would also mean that employees would have a greater selection (from ALL the plans out there) and could remain a customer of a health insurance company for life (if they so desired), which would give health insurance companies incentive to invest in/retain customers.

[2] because the negative impact of poor health decisions take so long to manifest themselves from the negative behavior e.g. getting cancer from smoking, heart disease or diabetes from being overweight

[2] so that information can be received about the patient to provide coordinated care, and so that information can be sent to the patient’s ‘medical home’ (their primary care provider)

© 2010 medullan | blog.