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Commentary: We need a health care system that puts patients in charge

POSTED: November 20, 2011 12:30 a.m.
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Nancy Desmond and Vincent Frakes

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For almost two years, Americans have lived in limbo, not knowing if the 2,770-page health reform law would forever change how we conduct the business of health care.

This week, we found out that an answer is not far away.

The U.S. Supreme Court has agreed to hear the legal challenge to President Barack Obama's signature health care law, drafted with little public input, created 159 new agencies, offices and programs and granted a litany of unchecked powers to a few Washington bureaucrats, most notably, the Commissioner of Health and Human Services.

The nine members of the nation's highest court will not only decide whether it is constitutional for the federal government to mandate that citizens purchase health insurance, but whether the federal government can force states to expand their enrollment in Medicaid.

The legal arguments to be heard next spring will be the Super Bowl of Supreme Court cases, and the court's ruling will be one of the most heavily-anticipated outcomes in years. It should have a profound effect on the 2012 presidential election as well as the health care industry, which represents more than one-fifth of the entire American economy.

But no matter what the outcome, we at the Center for Health Transformation will continue to advocate for a 21st century model of health reform. Whether the court throws out the entire law, upholds it, or rules parts of it unconstitutional, we believe there is a need to put in place legislation that focuses on a patient-centered model that lowers costs while improving health outcomes.

Successful health reform must not be a top-down federal approach, but instead one that allows states and individuals to devise health care models that work for them.

Among a few of the principles we would encourage Congress to also consider:

• Bold movement away from the traditional fee-for-service delivery model toward an outcome-based payment system. We must make payments to providers based on positive patient outcomes. A 21st century model encourages patients to be engaged in their own health care and creates incentives for doctors and hospitals when patients get well and less when patients keep returning to hospitals in a revolving door fashion.

• Advance consumer-directed health care. To empower patients with their own health care we should reform the tax code to encourage more Americans to set up health savings accounts. HSAs would allow consumers to pay for routine medical care, like we do for regular oil changes or tires on a car, and then utilize high-deductible insurance plans for major medical expenses. However, the new health reform law unfortunately taxed and restricted health savings accounts, dealing a blow to consumer-driven health care.

• Stop paying crooks through aggressive enforcement of criminal activity within Medicare and Medicaid and beef up state children's health care program fraud prevention programs. Some crooks claim it is more profitable to cheat the government in these programs than to deal drugs. The inspector general believes nearly 10 percent of Medicare cases are fraudulent. Hundreds of billions of dollars could be saved through better enforcement, whether it is rooting out nursing homes billing the government for deceased patients or criminals running HIV clinics at the back of pizza parlors.

• Encourage states to enact civil justice reform to prevent frivolous lawsuits that drive up health care costs. A Jackson Healthcare/Gallup physicians' poll last year found that 1 in 4 dollars spent on health care is dedicated to unnecessary tests, procedures and drugs that doctors order to prevent from being sued. As long as doctors play defense, health care costs will continue to escalate and drive up costs for all of us.

• Create additional federal incentives to ensure nationwide implementation of electronic health records by hospitals, physicians and other health care providers. An electronic platform not only reduces the chance for medical errors in treating patients, but also makes it more efficient and safer to transfer a patient's history from one provider to another.

These are but a few of the ways that we can incorporate solutions that will bring health care into the 21st century, put patients at the center of health innovation and achieve the No. 1 goal of saving lives while saving money.

Nancy Desmond, left, is chairman and CEO of the Center for Health Transformation, founded by former House Speaker Newt Gingrich. Vincent Frakes is the federal policy director for the Center.



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