By John Ballard
As we wait to find out how badly the Supreme Court will savage PPACA this reassuring post and comment appeared at The Health Care Blog.
I've been saying it for years now, it's the theme of Healthcare Beyond Reform: Doing It Right For Half The Cost - and now it's even hit the editorial pages of the NY Times: A June 2 editorial, "Treating You Better For Less," trumpets the "good news" about a "grass-roots movement" using "already proven techniques" that "could transform the entire system in ways that will benefit all Americans."
"It is a measure of how dysfunctional the system has become," says the editorial, "that these successful experiments - based on medical sense, sound research and efficiencies - seem so revolutionary." It goes on to describe several of the kinds of new ventures in efficiency and effectiveness that make up the core of Healthcare Beyond Reform, in different healthcare systems and health insurers across the country.
The news here is not that these things are happening, or that they are so widespread that they can be called a "grass-roots movement." The real news here is that the movement has gained such momentum that big, mainstream media organizations outside of healthcare, well beyond the policy wonk orbit, have begun to surface what may turn out to be the biggest story of our times: The largest sector of our economy turning inside out, like some movie transformer, on the way toward providing all of us with far better care for far less than we could possibly imagine. Better healthcare for half the cost.
There's a lot to it. This revolution may not be televised because of its very complexity, and the vast, subterranean, even tectonic nature of the structural economic changes causing the surface changes we are seeing. Nor will the movement stop if the ACA reform act is thrown out or gutted by the Supreme Court, or repealed by a new Congress and President, because the movement was not started by the reform law. It was generated by demographics and economics, the sheer unworkability of our current system, and the data power that allows us finally to see into it, to try new things, and measure their results.
Joe you write: "This revolution may not be televised because of its very complexity, and the vast, subterranean, even tectonic nature of the structural economic changes causing the surface changes we are seeing. Nor will the movement stop if the ACA reform act is thrown out or gutted by the Supreme Court"
Yes! The movement on the ground has a momentum of its own- within the health care industry (where hospitals have already invested in improving how they deliver care) ; in the insurance industry (where Aetna is now funding the IT for a group of hospitals- Aetna's CEO understands that going forward they will no longer be in the underwriting business, they'll be in the "keeping people healthy" business, among small businesses, that have begun taking up the offer of tax credits as they offer insurance to their employees, and in the general public where more and more people want and expect guaranteed issue, community rating, essential benefits, and subsidies-even if that means that some pay higher taxes.
As you say,economically, our current fragmented, inefficient, wasteful, for-profit health care system has hit a wall. Fewer and fewer employers and families can afford it. A great many doctors and nurses are very unhappy with the quality of care. And Americans are beginning to realize that we don't have "the best healthcare system" in the world.
Moral of the story -- Calm down everybody and don't worry about what might happen next. A critical mass of the people who really count -- health care and insurance professionals -- has been paying attention to the public discussions over the last two or three years. And the people who count, the winners of the future, are already taking steps in the right direction.
Not all of them are on the same page, but enough have caught the drift of the conversation to realize that if something is not done soon to improve the system -- making it less expensive and more widely available at the same time -- the future of both groups is in jeopardy. The word unsustainable is more than a political nostrum. The train is leaving the station. The political types with their polls, weathervanes and double-talk will eventually figure out what needs to be done. But improvements to the system are already happening, with or without Obamacare.
Just in case the legislation survives unmolested by the Supreme Court, go read 11 Facts about the Affordable Care Act.
To the extent that political types, judges and others tear at it, make mental note of who they are and the damage they are apt to cause.