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Obamacare or not, healthcare reform in progress

May 2, 2012
Dr. Richard Afable
Nine justices are expected to determine the fate of the Affordable Care Act in June, but they alone won’t determine the course of healthcare in this country.
That course has already been set.
Doctors, hospitals and patients know what politicians and pundits haven’t yet realized: The transformational reformation of health care is already in progress. And it will continue to move forward irrespective of what the Supreme Court decides.
Hoag and health systems across the country understand that political hot buttons don’t matter when you’re being wheeled into an E.R. We are not waiting for a Supreme Court decision. We are adapting and moving forward to the reality of a healthcare marketplace that is looking more and more like, well, a marketplace.
To today’s patient, price matters. In prior times, insurance companies picked up the tab for whatever test or treatment a patient underwent. The price was invisible to consumers, so they developed a take-it-all mindset that valued more care, even excessive care, over quality care.
Today, most people are no longer passive recipients of healthcare; they are active, price tag-reading consumers. As consumers, they are responsible for a greater portion of the financing of their healthcare – average deductibles are now $1,000, up from $50-$100 just a decade ago. Now that they’re paying for it, consumers demand healthcare to be effective, necessary and economical.
Just as they do with air travel, smart phones and most consumer goods, people are starting to shop around for their healthcare. This is good, as consumer choice and competition often lead to innovation, a reduction in price and an increase in quality.
But there is a downside: While the seriously ill will usually do whatever is necessary to get the best treatment, it is less clear what will happen when the need for medical care is not as clear or compelling. Annual physicals, cancer screenings, weight loss programs. We are working to prevent these types of preventative care options from being perceived as luxury, and therefore expendable goods.
One way the healthcare industry is doing that is by making healthcare more convenient. For example, Hoag is moving many medical capabilities out of the hospital and into the community. Last year, we performed screening mammograms for more than 37,000 women, and this year we will increase that number by as much as 10-15% due in part to new community-based breast centers in Irvine and Huntington Beach.
Just as convenience and proximity are important in a consumer-based world, so is price. Hospitals are working hard to reduce costs through innovations and new technologies. After all, we are also healthcare consumers, deciding which tools and technologies to invest in. When healthcare providers choose treatment options that prevent hospital stays and lead to fewer complications, we are reducing healthcare costs and help keep prices down as well.
At Hoag, our increased use of automated systems and telemedicine offer improved access to care that can lead to better outcomes and lower costs. Treatments that once required a hospital stay can now be performed successfully in an outpatient setting. And next-generation technologies can further reduce expensive hospital stays by monitoring chronic conditions at home and other ambulatory settings.
In the past, when patients were users of care rather than discerning consumers of care, any cost was okay and any treatment would suffice. In a consumer-based world, that’s no longer true. Regardless of how the justices rule, healthcare in the United States will never be the same. And that’s a good thing.
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