Someday soon the U.S. Supreme Court will decide the constitutionality of President Obama’s Patient Protection and Affordable Care Act. Those who think the court’s decision will close the barn door on the horse of health care reform should not cheer or despair; that horse is long gone. In fact, the whole darn herd of health care change has escaped and is now stampeding across the American health care countryside.
There will be no corralling that thundering herd. Raised on a steady diet of chaotic and inadequate health care, whipped into a state of desperation by ruinous health care costs and run to an exhausted lather by decades of failure of our leaders to fix these problems, the herd is now dubious about the benefits of that old barn.
One such horse is the patient as a new health services shopper. More than 140 million Americans who are self-employed or have employer-based health insurance now pay thousands of dollars each year directly out of pocket for health care, on top of their insurance premiums. They are learning that one can shop for some health care and thereby substantially cut those expenses. This is a rapidly developing and huge potential market force being applied to the simple and ruinous fact our health care has not been a price-sensitive service.
Nothing the Supreme Court decides this month will stop what this new market force will probably produce in the next few years — a race to the lowest price possible for some nonemergent health care services. These will include colonoscopies, MRI and CAT scans and many surgical procedures. Large profits on these procedures will disappear in many markets, saving consumers billions of dollars and threatening the existence of some hospitals that depend on profits in those areas to keep them afloat.
Health care of marginal value will be another target — the millions of tests, procedures and other treatments we get and pay for that do us little real good. For the first time ever this is coming under the concerted gaze of patients, families, employers, insurers, media and politicians. Most importantly, many physicians and health care organizations are now finally trying to lead the herd in an effort to trample wasteful care into the mud. Nine smart people in black robes can say anything they want about what is and is not constitutional in health care reform, but waste in health care is in for a sustained stomping, regardless of what they say.
Nor will smart health care organizations and physician groups change their new directions if the Supreme Court tosses the Obama-Romney health plan (Obama’s plan was largely modeled on Romney’s plan for Massachusetts) back to a yapping, tail-chasing US Congress. Those organizations are hell-bent on reducing the costs of their care because they know, no matter what happens in Washington, America is going to be spending less money on health care.
Many of those forward-looking organizations are figuring out how they can sell not just health care, but also the ability to manage health and health care costs. Those with enough patients and money may get into the business of insuring patients, not just taking care of patients, as the Kaiser Permanente health system has done. Forward-looking insurance companies are doing just the opposite; buying physician groups and getting into the business of taking care of patients, not just insuring patients. This turning of parts of the health care system on its head will not stop even if the court overturns the health reform law.
None of this means the Obama model for health reform is irrelevant; it’s the only real plan advanced in two decades to ultimately get every American insured. Strangely, it may be the last best chance for anything other than a single-payer, government-funded plan; if enough Americans lose their insurance over the next five years, frustrated voters may just demand Medicare for everyone, a simple, single-payer solution that may look more appealing as alternative options dry up.
If the Supreme Court tosses out the Patient Protection and Affordable Care Act, runaway horses will be running roughshod over many parts of our health care system. Some of that will be very painful.
Erik Steele, a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.
I suspect the real problem behind medical costs is first, that Americans have become hypochondriacs under a rolling barrage of sensational healthcare journalism and second, that medical providers have come to believe that they deserve to be loved and rewarded, but mainly rewarded. Put those together and you get a huge demand for high priced services.
I wonder what would happen if, instead of trying to satisfy every medical ‘want’, the government started a program to teach people that many medical ‘problems’ will go away if ignored? Heresy, I know….
Please, Americans are no different than any other population in the world. The costs have skyrocketed because of greedy insurance middle man getting a chunk of every dollar spent coupled with a sick insistence that medical care needs to be unregulated and for-profit.
Americans are no different than Europeans or asians, when we get sick, we want care. When we can’t afford it we either do without and get sicker or we get the care and the rest of society pays for it. The mandate in Obamacare is a very conservative idea that says you have to pay something towards your care since everyone needs it sometime. This is called personal responsibility and that is why the Heritage Foundation wrote the mandate language congress enacted.
The only reason they hate it now is because Obama is president.
Quite often, we get better on our own. Here’s a quote from examiner.com:
At least 80% of doctor’s visits are for self limiting, mild , inconvenient disorders. Most people in America today are almost conditioned to , too eagerly, run off to the physician’s office for minor matters.
No, it’s called taking away personal responsibility. ‘Personal responsibility’ is making a choice and taking the consequences.
And greedy insurance middle men hardly deserve to be singled out from the horde of greedy hospital administrators, greedy support personnel and greedy doctors: there’s enough grasping hands to go around. But the main thing is that Americans (and whether other nationalities also do it doesn’t matter) overuse medical care. That’s what drives the cash flow that makes the greed so attractive.
I am hopeful the Supreme Court will kill this beast; the whole beast. This is what happens when extremists shove something down our throats without listening to those with different views or approval. That’s problem number 1. The 2nd problem is we cannot afford this beast. Solutions must be found, that is for sure, but folks with a little remaining sanity must come together, and craft a more sensible approach.
I guess I must have missed the part where this thing was passed overnight and there were no “town hall” meetings held whatsoever.
Nice revision of history but entirely inaccurate. Shoved down our throats after a year of non-stop debate….Hmmmm. We can’t afford it….(it is projected to save $100B per year once fully in force.) Extremist: has not broken up a big bank, has tightened border security, increased deportations, increased oil production, kept EPA from enforcing carbon dioxide limits, and prevented any terror attacks, and cracked down on marijuana and drug interdiction.
You can call that extreme but it is not objectively true.
His record is more conservative than George HW Bush and Reagan on taxes, wall street and spending growth. Nice try but you are one seriously mislead individual and you are not alone.
You may look at the premium amount and think that there is no way that you can afford it. You cannot afford to be without health insurance! shop around you may find it easy to find an affordable premium, I always find health insurance through “Penny Health” network.
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