Raising Women’s Voices

The NEJM gives solutions

Posted in DC Reform, Health Disparities, Health Reform Policy Proposals by raisingwomensvoices on July 10, 2009

Yesterday the New England Journal of Medicine released an article written by Michael Porter that outlines the solution to health care reform. He breaks it up into a series of steps before and after reform.

In the face of a significant aging population in this country and the development of new medical technologies, Porter makes the case for an increased value-based system of health provision where “the central focus [is] increasing value for patients – the health outcomes achieved per dollar spent”. He states that “achieving and maintaining good health is inherently less costly than dealing with poor health” and that the two goals should be universal coverage and a complete restructuring of the care delivery system. His suggestions for doing this are as follows:

1. Changing the basis of health insurance competition: companies should do well when they take care of their patients. This seams obvious, but right now insurance companies benefit when they provide lots of care, not necessarily the best care. Porter also suggests the removal of things like gender and age ratings and discrimination against individuals with preexisting conditions. In addition, health plans should be required to report the outcomes of health care they cover. All of these things point back to the basic premise of a value-based system.

2. Porter asserts that employers should be kept in the system because they depend on the performance of their employees, so they are interested in keeping them healthy.

3. Fix the burden that has been put on individuals who have no access to employer-based coverage.

4. Porter makes the case for larger pools that will spread out costs.

5. Financial support for individuals of lower-incomes will help them get health insurance and therefore stay healthy.

6. Everyone should be required to purchase health insurance so as to spread out the costs and everyone is included.

Porter also emphasizes the importance of measuring and disseminating health outcomes so everyone knows which health providers offer the best care. Preventive services are essential to the change in attitude about health care. Consumers need to be encouraged to address health concerns before they become health emergencies. A better reimbursement system would benefit everyone, as would electronic medical records that help measure outcomes.

Check out the full article here, and let us know what you think!

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