Yesterday’s meeting at the White House between a coalition of health trade groups and President Obama has been widely reported There is considerable skepticism as to the real motivation behind the plan from the coalition to reduce the growth rate of spending by $2 trillion over the next decade. By doing so – a reduction of 1.5% in the growth rate from a projected 6.2% annually – many observers see that the growth rate would then be manageable. The consensus seems to be that the coalition wants to be a player in the health reform discussion rather than sniping from the sidelines as change rides right over them. So the coalition put together this letter and delivered it yesterday, and it was well received by the Obama team.
As health care financing moves along – and it is moving along – a public plan is being considered as a stand along with private plans. At least some of the players, notably the Association of Health Insurance Plans (AHIP), are deathly afraid of a public plan, a la Medicare – which is (1) enormously popular (2) notably cost efficient and (3) cheaper for the consumer. In short, a public plan could give private plans a run for their money (pun intended). Interviewed by MedPage Today in April, Karen Ignagni, president and CEO of AHIP, said that hitting the 1.5-percentage-point target would make the public health insurance plan favored by Democrats unnecessary.
Really, really, really “L”.
This all said: we are seeing a group of differing interests coming together and making a pledge to be part of health care reform, not just to fight it. If they fight, they will lose, and I really don’t believe that the AMA and the SEIU (Service Employees International Union) are going to go along with opposing President Obama’s efforts. AMA President Dr. Nancy Nielsen can tell some compelling, personal stories of being without health care insurance.
Yes, we can poke holes at the letter and the strength of the commitment. But they are facing a popular president, a population who, the right wing rhetoric to the contrary, does pay a significant (and often painful) portion of healthcare costs, and wants change.
The forces are coming together to move towards a mandated, universal coverage system. For physicians and other providers, they will have to deliver on ratcheting down the cost of services. My bet is that will be a mix of public and private plans, so that people – and employers – will be able to add onto coverage, much the way you have different levels of auto insurance and homeowners insurance. We mandate auto insurance, we can mandate health insurance.
Fees will come down – there is movement afoot to shift reimbursement monies from specialists to primary care docs. The specialists will try to fight it – and will lose.
So: your challenge is to get on board with what are viewed as best practices, and the clinical guidelines coming from your specialty. This does not mean that you will never deviate from a guideline is your judgment is that such as move is in the best interest of a particular patients, or even many patients.
The last step is to work on transforming and reorganizing your practice. You must become more efficient in your practice operations while protecting the time that physicians spend with patients. You need to go back, break down the entire patient experience and change the way you do things to make the visit faster, cheaper (to you)