Now that Cover the Uninsured Week has passed, it's time we got serious about addressing the problem. How much longer will we tolerate the cost and consequences of a broken health insurance system where millions have no coverage? So far we have made very little progress. Yet the value of covering the uninsured is estimated by the Institute of Medicine to be as high as $130 billion annually measured in terms of better health and longer life for our nation's uninsured. Why aren't we working harder on this problem?
We are having lots of conversation, nationally and locally, about the cost of health care, and about the latest notion in health insurance, consumer-driven health care.
But we really must not forget the millions of our fellow citizens who are without health insurance of any kind, and who therefore don't have full access to our health care system. There are about 45 million people in America without health insurance and that census number likely understates the real magnitude of the problem.
In light of my recent blog entry about electronic health records (March 2, 2006), I’d like to provide a link to an editorial in the current issue of the Annals of Family Medicine: “Keeping our Eye on The Ball: Managing The Evolution of Electronic Health Records.”
The editorial was co-written by several authors, including two distinguished professors at UNC: Warren Newton MD, MPH and Donald Spencer, MD, MBA.
Please enjoy our continued discussion of this topic.
Last week the state of Massachusetts embarked on an innovative path to solve the problem of the uninsured. The legislature and the governor collaborated to pass legislation that will require all citizens to buy health insurance. This is modeled on the many state laws around the nation that require you to have car insurance. The Massachusetts plan also includes assistance to low income people to enable them to buy their health insurance.
The latest innovation in health care financing goes by the buzz words consumer driven health care.” The essential features of CDHC are high-deductible health insurance plans, usually with a health savings account (HSA) for the insured person to use to pay the high deductibles and co-payments. The notion behind these plans is for individual Americans to have to make decisions about when and where to seek health care services. Since these patients will be paying for the large deductible from their own HSA or out of their own pockets, they will be much more cost sensitive and careful. These plans have shown that they can be effective in holding health care costs down, presumably by avoiding unnecessary or too expensive care.
Electronic medical records hold great promise for improving quality of care. Development of a national electronic health records system, however, is progressing slowly. Today, less than ten percent of physician practices use an electronic medical record. It surprises me that some health care professionals still question the benefit of moving from paper to computerized records. It's time all health care providers large and small embrace and invest in medical records technology for the benefit of their patients.
I was a bit disappointed that the President did not spend more time discussing health care in his State of the Union address last week. I hope people listening did not conclude that the issue is dramatically less important than addressing terrorism, improving education or reducing dependence on foreign oil. The points the President did emphasize about personal ownership and responsibility for one's own health care underpin the details of his health care policy. Those details will be discussed and debated over the next several months in a manner that I hope will fully inform consumers about their important role in consumer driven health care.
I was in Washington, DC, this week, and was able to meet with several senior leaders on the national health policy scene.
I talked, separately, with Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission, with Mark McClellan, MD, the administrator of the Centers for Medicare and Medicaid Services, and with Alex Azar, the deputy secretary of Health and Human Services.
As we watch some of our fellow citizens begin to recover from Katrina, and watch others get ready for or get out of the way of Rita, our national news seems to be all hurricanes, all the time.
Surely there are health aspects of these stories ? the public health implications of polluted water, the damage to hospitals and other health care institutions, and the psychological aspects of the trauma, among them.
Recently, the UNC Heath Care Board of Directors approved new policies that will guide our provision of care to uninsured and indigent patients. Serving those who have no other place to go has been key to the mission of this institution for more than half a century, but these new policies are intended to enhance and streamline what we do.