“Not directly addressing the true underlying problems in our health care system, i.e., cost, payment reform, more efficient delivery systems and even tort reform, seems more founded in politics than a desire for true reform.”

During the health reform debate, I frequently complained that nothing actually controlled costs despite the fact that politicians repeatedly said that was the goal and then the result. Of course, what we got was health insurance reform expanding coverage to millions more in an environment of out of control costs.  Here are a few excerpts from an interesting article. You can find the full article here. 

Studies estimate that up to 30 percent of medical procedures performed are unnecessary. Without a national commitment to evidence-based health care decisions, spending will continue to spiral upward and cost controls will be ineffective. And unlike with NICE in Britain, evidence-based health care recommendations in the United States are currently proposed to be only advisory.

While the legislation passed in March is really mostly just health-insurance reform, the good news is that many people who today cannot purchase health insurance will be able to do so. In the short term, that growth in the coverage and the underlying regulations, such as those eliminating coverage limits and consideration of pre-existing conditions may drive up health insurance premium costs for everyone. Though the goal of expanding coverage is laudable, the timing could not be worse. To spend the amount of money currently projected on this limited type of health care reform in the worst recession we have had in generations, yet not directly addressing the true underlying problems in our health care system, i.e., cost, payment reform, more efficient delivery systems and even tort reform, seems more founded in politics than a desire for true reform.

No single policy or program will bend the cost curve. I believe it will take a combination of private and public initiatives. Integrated health-care delivery systems, such as Sentara, can reduce costs through economies of scale, the use of best practices and alignment with physicians to achieve greater coordination and efficiency. New technologies such as electronic medical records will improve safety, quality and efficiency. And evidence-based decisions must enter the equation, whether through well-researched official guidelines or informed decisions by patients themselves in their advance medical directives. We also need a good dose of preventive care, with an emphasis on individual responsibility to exercise, control diets and have positive safety habits.