By Evan Falchuk
The New York Times has been running a series on its Economix blog about health care reform.
Today, they post answers to following the questson from three health care experts: “What should our priorities for health care reform be?”
You should read them all, but you should think about two things.
First, Don Berwick’s response was most interesting. As the head of the Institute for Healthcare Improvement, Berwick is one of the most respected advocates for patient safety and health care quality. Like me, he worries that focusing on money over medicine misses the bigger point:
To get the care we need and want for everyone, without courting national bankruptcy, “reform” had better mean “changing care,” not just “covering care. So far, it doesn’t.
Oh, all the speeches have the phrase “delivery system reform” embedded somewhere in the list of components of health care reform. But that frankly looks to me like listing, “Use an airplane,” somewhere on a list of components of flying. It’s not an afterthought; it’s the core. Attending to the difficult task of actually rebuilding our broken health care delivery system ought not to be one among many tactics of change; it ought to be the central point – the single most important aim of changing health care policy.
Berwick concludes that we don’t have a “shared vision of the health care system we want and need.” He’s right, and it’s a point I’ve been trying to make, too.
And this is the second thing you should think about in reading these excellent responses.
Why, only five weeks from the President’s August 1 deadline for reform, are we just starting to have a conversation on what our priorities for health care reform ought to be?
Hi, Evan:
You got that right – while changing health policy will help allow healthcare reform to take place, the true reform that is REAL needs to be at the ground, bottom-up changes. That’s why I believe the National Priorities Partnership (NPP), convened by the National Quality Forum, is so critical, and I am surprised none of those interviewed mentioned it. The NPP identifies 6 priorities for reform, and all kinds of organizations are aligning their work with these priorities, including ours, the American Society of Health-System Pharmacists. I think that SIGNIFICANT progress can be made on these priorities when we get clinical pharmacists involved in providing care to patients, which is demonstrated to improve outcomes, prevent errors, and reduce costs!
Is there still hope for influencing real, effective, sustainable reform? There’s a part of me that hopes Washington fails to come to a concensus. That would buy more time for someone to come up with real solutions that address real cost drivers. There are people out there with great ideas. They just need to be brought together, and quickly.
As someone with a position right in the thick of the healthcare system, with daily access to nearly all stakeholder groups, I would love to be at the table with a group that can produce real solutions.
Good observations, Deron.
There is so much real-life innovation happening at employers and in hospitals and medical practices, but it gets lost in the political debate over whether or not we need a publicly-funded health plan.
It’s too bad, because these things are important and having a real impact on the issues of cost and quality that are under discussion.