ObamaCare: Not a tree, But a Forest

30 Mar

ObamaCare; Not a Tree, But a Forest.
Louise Annarino
March 30, 2012

“The Best Time To Plant A Tree Was Always 20 Years Ago. The Second Best Time Is Always Today.” ~ Old Chinese Saying  

While every other industrialized nation has already assured universal health care for its citizens, the United States has not. Other presidents tried unsuccessfully to enact universal health care. It took President Obama’s pragmatic efforts to get the country this far. We still have far to go. It does not make economic sense to continue hi-tech health delivery system underpinned by a profit motive. A single payer system, removing the profit motive, is more efficient and cost-effective.

Dr. Atul Gawande’s insights caution us to not focus on cost over care. http://www.npr.org/2011/01/19/132931975/lowering-medical-costs-by-providing-better-care . His influence was written into ObamaCare, which offers free preventive care, researches and pays for quality outcome rather than billable minutes. ObamaCare is controlling costs by controlling quality, while extending coverage. An amazing accomplishment.

If allowed to become fully implemented ObamaCare will continue to shift what Evan Falchuk calls our misguided focus. “The misguided focus on saving money over good medicine means we get neither.  The surest way to save money is to make sure that patients get enough time with their doctors, who need to be able to use their training and judgment to help their patients make the right decisions.  It’s a global problem, but America suffers from the most exaggerated version of it.” Warning: Graphic Politics By Evan Falchuk, http://www.seefirstblog.com/2009/12/25/warning-graphic-politics/

Spending more money does not guarantee a better outcome. As of 2009, the “US still shows a dramatic divergence from the other countries, spending more than twice as much for a slightly below average life expectancy.” Graphing The Cost of Health Care by Jon Peltier,December 30th, 2009 Peltier Technical Services, Inc., Copyright © 2012. See chart at:Graphing The Cost of Health Care | Peltier Tech Blog | Excel Charts http://peltiertech.com/WordPress/graphing-the-cost-of-health-care/#ixzz1qceLwkVw. ObamaCare includes on-going reviews to determine what does/does not improve treatment outcomes; assessing quality while reducing costs.

In 2010 an analysis by Drs. Orszag and Emanuel in The New England Journal of Medicine summed up the multifaceted approach which makes ObamCare so promising and so confusing.”The ACA not only will extend health care coverage to millions of Americans but also will enact many policies specifically aimed at reducing the amount we are spending on health care and, by changing the delivery system, reducing the rate of growth in health care costs over time. Indeed, one of the essential aspects of the legislation is that unlike previous efforts, it does not rely on just one policy for effective cost control. Instead, it puts into place virtually every cost-control reform proposed by physicians, economists, and health policy experts and includes the means for these reforms to be assessed quickly and scaled up if they’re successful. By enacting a broad portfolio of changes, the ACA provides the best assurance that effective change will occur. Moreover, by taking a multifaceted approach that includes hard savings plus the mechanisms for creating a dynamic health care system, it enables physicians, hospitals, and other providers to consistently improve outcomes, boost quality, and reduce costs as health care evolves.” http://www.nejm.org/doi/full/10.1056/NEJMp1006571

Whatever the U.S. Supreme Court rules, I am convinced we will have universal health care soon. For reasons both humane and cost effective, we cannot afford not to do so. A single payer system, medicare for all, would best serve both purposes. The second best time to press for universal, single payer health system may be now. We should have planted this tree long ago. The U.S. Supreme Court may uproot or prune the sapling. We will continue to plant. ObamaCare is not a single tree, but a forest.


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