Summary of Comments:
- A long way to go to improve US Healthcare
- "US Best Healthcare System" is a myth
- Value = (Access + Quality) / Cost
- Healthcare is a pyramid: bottom is wellness promotion; top is the most "sophisticated technological applications of healthcare".
- Every other society starts at the bottom and work their way up until the money runs out.
- America starts at the top and works its way down until the money runs out.
- Thus we pay a whole lot more.
- We don't make good managers of our healthcare system.
- We need to delegate out the managerial responsibility of healthcare as we delegated out the responsibility of our monetary system to the Federal Reserve over 100yrs ago.
- 45% of people in the us get their healthcare from a government driven system; 55% from private sector.
- Congress should not decide health policy just as Congress should not decide interest rate policy.
- We need transparency in healthcare.
- 100k people die every year due to medical mistakes.
- We don't use "standard of care" in healthcare.
- "We have a 19th century administrative room but a 21st century operating room"
- We need to bridge the gap with IT.
- We need payment reform.
- We currently reimburse by procedure; we need to reimburse by episode.
Given that Tom Daschle will be the person driving the direction of healthcare reform, there is a heck of a lot of people examining every comment that he makes. This is my take of his direction based on these comments: 1) Emphasize wellness; 2) Take healthcare policymaking away from congress; 3) Continue to increase transparency in healthcare; 4) Change reimbursement from procedure to episode.
Note that this video was recorded on June 17, 2008.
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I wonder if Mr. Daschle has changed his position on delegating the managerial responsibility in healthcare since the downfall of our economic system.
ReplyDeleteMedicare reimburses by episode as well, they are known as DRG's, the procedure simply puts the bill in a payment bracket. Hospitals made more money under the DRG system in the 80's and 90's because government had no idea how to reign in spending. I believe they learned their lesson and have closed many of the loopholes with MS-DRG and Present on Admission. They now will have a clearer picure of the hospital stay and what portion of the bill was derived from a defect in care and not pateint's condition prior to entering the facility. It is going to get interesting as healthcare gets scrutinized more and more.
There is a health blog associated with the Wall Street Journal. It recently quoted Daschle referencing the Fed Reserve system again. I don't think he's given up on the idea.
ReplyDeleteGiven that Daschle, Obama, and CMS are not yet singing the same reform song, I think we're in for quite a battle as each tries to exert their new vision for healthcare.