Sunday, April 12, 2009

Health Insurance With A Warranty?

The health insurance system in America is terminally ill. Americans have the highest health care costs on the planet. You’d think that expenditures like that would result in the healthiest population on the planet.

That is not the case.

For all our costs, the general health of Americans doesn’t stack up well against other Western nations. America has an intolerably high infant mortality rate, as well as a growing list of chronic diseases, including heart disease, diabetes and cancer.

To compound the problem, the economy is crashing, leaving millions more without health insurance. An estimated 48 million Americans are without health insurance. As businesses downsize and close, more Americans lose coverage. This crisis will give Congress and the Obama Administration the political cover to finally nationalize health care in the United States.

But is that the best way to solve the problem?

Some health care providers are innovating in a quest to provide higher quality care while controlling costs. One shining example is the Geisinger Health System in Pennsylvania.

Geisinger Health System serves 43 counties across Pennsylvania, accounting for over 2.6 million patients who are served by over 750 doctors.

Geisinger is perfecting a new method of health care that rewards doctors for taking better care of their patients, rather than the traditional way of paying them for the sheer number of patients they can see and the special treatments they get. So far, Geisinger is finding that quality improvement may actually reduce overall costs.

W. Edwards Deming, the father of Total Quality Improvement, would be proud.

Geisinger has developed a system that incorporates important strategies such as:

• Coordinated primary care - a team of doctors, nurses, technicians and a case manager coordinate all care for each patient, especially those with chronic conditions like heart disease, pulmonary disease or diabetes. They do what is best for the patient, not what is most convenient for the provider.
• Surgery with a warranty - typically, if you have to return for complications from surgery, you incur new health care costs. Not at Geisinger. Starting with cardiac surgery, they began offering a 90-day warranty at the same time they instituted checklists of best practices for surgical procedures. It has lowered readmission rates by44%.
• Electronic health records - the new records system allows doctors and patients to all access the same patient information with a mouse click. Patients and doctors can email each other, schedule appointments and patients can monitor their own progress.
• Patient involvement - encourages preventative health care, such as lifestyle changes.

These are the kinds of innovation that will always be found in the free enterprise system. Geisinger Health System is a for-profit company with revenues over $3 Billion per year. The profit motive is notably absent in all government activity, innovation and efficiency are seldom found there.

I don’t believe that government control of the health care of the nation is a good solution to the myriad problems. For the best example of government-run health care, look at the failures of the Veterans Administration. The Federal government has botched a system that affects only a few million people. We can only dread the day when Washington takes over health care for the entire nation.

No comments: