HSA Tool For Employers And Their Employees
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Customer-Driven Medicine: How To Create A New Health Care System
Darrell M. West, Vice President and Director, Governance Studies
The Brookings Institution
Executive Summary
Thursday, October 08, 2009
10:00 AM to 11:30 AM
Washington, DC
Health care today is dominated by physicians, hospitals, the pharmaceutical industry, insurance companies, and government agencies. Patients seek to navigate their health care by moving across a variety of providers, ordering prescription drugs from pharmacies, and seeking reimbursement from either public or private insurance plans. They spend hours connecting the dots and working out the best health care for themselves and their families. If they are fortunate to have good providers and effective follow-through, they receive high-quality health care.
Imagine a different system where, with the aid of the Internet, electronic medical records, cell phones, and personalized health care, the patient is in charge. People monitor their own weight, blood pressure, pulse, and sugar levels, and send test results via remote devices to health care providers. Patients store their medical records online and have access regardless of where they are in the United States or around the world. They get personalized feedback via e-mail and reminders when they gain weight, have an uptick on their cholesterol levels, don’t take their medicine, or have high blood pressure. Social networking sites provide discussion forums and the benefit of collective experience from other people suffering similar problems. Patients take responsibility for their routine health care and rely on physicians and hospitals for more serious medical conditions.
This system is not a futuristic vision, but is well within our grasp. It would cut costs by reducing professional responsibility for routine tasks and record-keeping, while also making it possible for patients to receive higher quality care and be more satisfied with the end-result. The technologies for this kind of system transformation currently are available through cell phones, remote monitoring devices, video conferencing, and the Internet.
In this paper, I outline a vision for a new health care system based on mobile Health (mHealth), remote monitors, electronic medical records, social networking sites, video conferencing, and Internet-based recordkeeping. It incorporates email reminders to take medicine, a NetFlix-style mechanism to rate experiences with doctors and hospitals, and websites that make ratings publicly available to employers and other patients. Today, there are nearly as many mobile phones (600 million) in existence that can browse the Internet and access email as there are personal computers (800 million).
In order to bring this system to fruition, though, several changes are needed to encourage customer-driven health care. There have to be shifts in public policy and private health care that get the incentives right for patients, physicians, insurers, and hospitals. If we make these changes, we can cut costs while also improving quality and public satisfaction with health care.
Among the specific changes that are required include:
- changes in public and private insurance coverage that reimburse health care providers for mHealth care, remote monitoring, electronic communications with physicians, e-prescribing, and downloading medical tests to cell phones and other mobile devices;
- rewarding physicians who provide positive health outcomes for their patients, as opposed to paying them for the quantity of tests they have ordered;
- greater patient encouragement for preventive health care, good diet, and regular exercise activities and creation of a Preventive Medicine Fund that covers gym memberships, exercise equipment, flu shots, diet advice, smoking cessation programs, and substance abuse treatment;
- development of a good health rewards program similar to good driver discounts that provides benefits to patients who lead healthy lifestyles.
Related Content
Digital Health and Participatory Medicine
Darrell M. West, The Kojo Nnamdi Show, August 12, 2009
Darrell M. West, Reuters, July 10, 2009
Kneale: Save ObamaCare – By Killing It
Published: Monday, 21 Sep 2009 | 12:41 PM ET
President Obama’s health-care revolution is dying before it hits the House floor. Now killing Obamacare is key to saving any semblance of health-care reform.
Instead of whipping this dead horse, the Obama Posse should wage a broad retreat and return with a spare, stripped-down, less-is-more plan.
Especially worrisome for the rookie in the White House, this ailing health plan has ignited a far broader and higher-stakes fight over how much government we really want, and what kind.
Do you really want the feds forcing you to buy insurance and taxing your family almost $4,000 a year if you refuse or decide you can’t afford it?
That’s what happens when health coverage–a personal responsibility of each of us–is transformed into an obligation of government, which now supposedly must provide it for all of us.
We simply can’t afford it. Rather than aim at all 300 million of us, an ObamaLite overhaul should narrow the target to two groups:
First: The 15 million or so Americans who are the Truly Uninsured: they want coverage, can’t afford it and don’t qualify for government help. So let’s give them some help.
Second: the 12 million who buy individual freelance policies rather than get coverage on the job. They need easy online access to a newly formed marketplace with interstate competition among the nation’s 1,300 private insurers.
Wait a minute–we have 46 million uninsured, based on the latest U.S. Census data. Why help only that first one-third? Because, among all the uninsured, one-third are people who could afford insurance but elect to take the risk of going bare.
Which is their right–until Bam & Co. take it away as the Baucus bill would do.
Another one-third of the uninsured already qualify for government help a la Medicare (for the aged) or Medicaid (for the poor). They just haven’t signed up because they’re too proud, lazy or clueless–or they are illegal aliens.
This scandalizes Democrats, the notion that two-thirds of the uninsured are partially at fault for their own going-bare status.
The other night, two liberal Democratic congressmen, Anthony Weiner of New York and Robert Andrews of New Jersey, accused me of passing along bogus statistics on this score.
They called the figures “hearsay” and “made-up.” But it turns out the figures come from Congress’s own non-partisan Congressional Research Service. Take a look at how Rep. Andrews responded (in the video); suffice it to say he refused to apologize.
It would be one thing if Obamacare’s universal, mandatory coverage would actually lower health costs. But it won’t. Covering more people will simply result in higher costs for more drugs, more devices, more surgeries and more visits to the doctor and the hospital.
That’s why the less-is-more plan should hold sway.
After narrowing Obamacare at the start to just the Truly Uninsured–the 15 million lower-income folks who want coverage but don’t qualify for government help-we also should make them pay some portion from their own wallets.
For them, Obamacare could cover, free of charge, catastrophic care and chronic care (for five often preventable diseases that pose over half of all costs: cancer, diabetes, heart disease, stroke and pulmonary disease).
That “doughnut” would leave recipients to cover the hole in the middle: regular doctor visits for routine ailments and maintenance.
One big cost problem we already have is a function of too much insurance.
Some 50% of all healthcare costs already are paid by government. Employer health plans cover the other biggest chunk. And only a sliver of the total cost is paid directly out of our own pockets.
If that personal portion went up, only then would we behave as tougher, smarter shoppers and worry more about keeping our own expenses down.
© 2009 CNBC.com
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
© IQ Financial Group, llc.
Arizona Department Of Insurance
The mission of the Arizona Department of Insurance is to faithfully execute the state insurance laws in a manner that protects insurance consumers and encourages economic development. Click to be directed to AZDOI.
Get quotes for individual/family health insurance in Arizona here. Contact us today at 602-510-7507 to find out how an HSA can benefit you.
IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
© IQ Financial Group, llc.
Arizona Health Care Cost Containment System (AHCCCS)
Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency that offers health care programs to serve Arizona residents. Individuals must meet certain income and other requirements to obtain services. Click here for more information about AHCCCS.
Get quotes for individual/family health insurance in Arizona here. Contact us today at 602-510-7507 to find out how an HSA can benefit you.
IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
© IQ Financial Group, llc.
WebMD Better Information. Better Health.
WebMD provides valuable health information, tools for managing your health, and support to those who seek information. Click here to begin accessing information.
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
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Michael Porter, Harvard Business School Professor on Health Care Reform
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
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Toby Cosgrove, Cleveland Clinic President & CEO – Reform Model
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
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Aetna CEO On Health Care Reform
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
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Sen. Baucus Introduces Senate Financial Committee Health Bill
The following announcement was released by the office of Senate Finance Committee Chairman Max Baucus (D,Mont.). Click here to read article and specifics about the proposed bill.
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IQ Financial Group, llc. is a licensed insurance agency in the state of Arizona. We offer a complete selection of health insurance, term life insurance, disability insurance, long term care insurance and supplement plans to individuals, families, self-employed and small businesses throughout Arizona. We offer the best in Arizona Health Insurance.
© IQ Financial Group, llc.