When did so many of our elected leaders become so uncompromising on health care?
Was it the moment when many in the Democratic field raised their hands in support of providing subsidized health insurance to all undocumented immigrants? That’s a position that even our peer countries with better coverage rates have yet to embrace. Maybe it was when President Trump and the Republican-controlled House celebrated their temporary takedown-without-a-replacement of Obamacare back in 2017. Their plan would have deprived an additional 24 million Americans of coverage had it cleared the Senate. (It thankfully didn’t.)
It’s hard to pinpoint the exact moment when the pursuit of the perfect — Single payer no matter the cost! The free market will fix it all! — has become the enemy of actual political progress in reducing the high cost of coverage.
What is marketable on Twitter has come to overshadow any incentive to focus on what’s truly achievable in the short term. Joe Biden’s health care platform, progressive by many standards but bounded by reasonable limits, was actually deemed “a giant gamble” because it isn’t progressive enough, even though it supports a public option and bolstering Medicaid expansion.
If this is a gamble, what does a bipartisan theory of health care reform even look like?
Let’s start by moving past the endless debate about the proper role of government in American health care. The right wants less government, the left wants more. We’ve tried since the Truman administration to reconcile these opposing views, and until our politics fundamentally change, it’s time to shift focus.
Elected leaders should instead get creative and use the convening power of Congress to support innovations that have the potential both to sharply reduce the overall costs of health care and to make it available to more people. Spending on health care in the United States remains absurdly high, having increased 3.9 percent to $3.5 trillion dollars in 2017.
Yet 31 million Americans will remain uninsured even if the Affordable Care Act is fully carried out by 2024. And among those with insurance, over half of those polled recently by the Kaiser Family Foundation and Los Angeles Times said coverage remains unaffordable because of high deductibles, expensive prescription drugs and insufficient coverage of pre-existing conditions.
Congress could aim for an easy win in reducing health care costs by exploring digital innovations. This is not a silver bullet, but it could have significant impact without stoking tribal warfare.
Recent studies have shown that technology can reduce costs. A team of Stanford scientists, for example, found that home-based digital monitoring of patients with chronic kidney disease allows for earlier intervention and better tailoring of therapies. This reduces hospitalizations, emergency room visits and the need for expensive therapies like hemodialysis, a treatment for people with failing kidneys. If broadly put into use, telemonitoring could save an estimated $63 billion annually.
Other home-based digital monitoring strategies — using cloud technology and devices like smart watches and phones — have improved the ability of clinicians to detect early symptoms of decline in patients with chronic respiratory disease. Such early detection helps reduce the need for costly hospital readmissions and other clinical services.
Some argue that app-based smartphone interventions could also save up to $46 billion annually by streamlining care for patients with chronic cardiovascular or respiratory ailments, who can access treatments before minor problems become major crises.
These examples say nothing of the staggering potential of artificial intelligence to improve diagnostic precision and reduce avoidable errors. Google recently released findings from a study that showed its A.I. system reduced lung cancer misdiagnoses by 11 percent when compared to the performance of human radiologists. This has potentially enormous implications: Diagnostic errors are expensive, adding an estimated $750 billion to our health care spending annually.
There has been some progress on these fronts. The Center for Medicare and Medicaid Services recently signed off on its first digital health reimbursement plan, which will reward providers for using remote monitoring and telehealth services.
But we are far behind our peers. Britain’s National Health Service has adopted a broad, government-sanctioned digital health strategy intended to integrate private sector innovation into public health.
Congress can play a leading role in this effort, finding funds for a new national institute dedicated to digital health innovation. Such an institute could fund research, convene stakeholders and provide regulatory guidance to the Food and Drug Administration regarding new technologies.
There’s so much else Congress could do that needn’t invite reflexive partisanship, such as reducing the unbearably high costs of end-of-life care, filling persistent gaps in palliative care services and improving research into novel forms of primary care that have shown initial promise.
Fixing our health care system should be rooted in common sense, not zealotry. For the Democratic candidates who will debate the next two nights, this is an opportunity to reverse the script. Minimize the talk of Medicare for all and instead push for creative solutions that are more realistic.
Let’s hope our leaders can agree to agree for a change.
Vinay Gupta (@VinGuptaMD) is an assistant professor of pulmonary and critical care medicine at the University of Washington and a major in the United States Air Force medical corps.
The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: [email protected].
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Home » Analysis & Comment » Opinion | Fix Our Health Care System. Don’t Try to Make It Perfect.
Opinion | Fix Our Health Care System. Don’t Try to Make It Perfect.
When did so many of our elected leaders become so uncompromising on health care?
Was it the moment when many in the Democratic field raised their hands in support of providing subsidized health insurance to all undocumented immigrants? That’s a position that even our peer countries with better coverage rates have yet to embrace. Maybe it was when President Trump and the Republican-controlled House celebrated their temporary takedown-without-a-replacement of Obamacare back in 2017. Their plan would have deprived an additional 24 million Americans of coverage had it cleared the Senate. (It thankfully didn’t.)
It’s hard to pinpoint the exact moment when the pursuit of the perfect — Single payer no matter the cost! The free market will fix it all! — has become the enemy of actual political progress in reducing the high cost of coverage.
What is marketable on Twitter has come to overshadow any incentive to focus on what’s truly achievable in the short term. Joe Biden’s health care platform, progressive by many standards but bounded by reasonable limits, was actually deemed “a giant gamble” because it isn’t progressive enough, even though it supports a public option and bolstering Medicaid expansion.
If this is a gamble, what does a bipartisan theory of health care reform even look like?
Let’s start by moving past the endless debate about the proper role of government in American health care. The right wants less government, the left wants more. We’ve tried since the Truman administration to reconcile these opposing views, and until our politics fundamentally change, it’s time to shift focus.
Elected leaders should instead get creative and use the convening power of Congress to support innovations that have the potential both to sharply reduce the overall costs of health care and to make it available to more people. Spending on health care in the United States remains absurdly high, having increased 3.9 percent to $3.5 trillion dollars in 2017.
Yet 31 million Americans will remain uninsured even if the Affordable Care Act is fully carried out by 2024. And among those with insurance, over half of those polled recently by the Kaiser Family Foundation and Los Angeles Times said coverage remains unaffordable because of high deductibles, expensive prescription drugs and insufficient coverage of pre-existing conditions.
Congress could aim for an easy win in reducing health care costs by exploring digital innovations. This is not a silver bullet, but it could have significant impact without stoking tribal warfare.
Recent studies have shown that technology can reduce costs. A team of Stanford scientists, for example, found that home-based digital monitoring of patients with chronic kidney disease allows for earlier intervention and better tailoring of therapies. This reduces hospitalizations, emergency room visits and the need for expensive therapies like hemodialysis, a treatment for people with failing kidneys. If broadly put into use, telemonitoring could save an estimated $63 billion annually.
Other home-based digital monitoring strategies — using cloud technology and devices like smart watches and phones — have improved the ability of clinicians to detect early symptoms of decline in patients with chronic respiratory disease. Such early detection helps reduce the need for costly hospital readmissions and other clinical services.
Some argue that app-based smartphone interventions could also save up to $46 billion annually by streamlining care for patients with chronic cardiovascular or respiratory ailments, who can access treatments before minor problems become major crises.
These examples say nothing of the staggering potential of artificial intelligence to improve diagnostic precision and reduce avoidable errors. Google recently released findings from a study that showed its A.I. system reduced lung cancer misdiagnoses by 11 percent when compared to the performance of human radiologists. This has potentially enormous implications: Diagnostic errors are expensive, adding an estimated $750 billion to our health care spending annually.
There has been some progress on these fronts. The Center for Medicare and Medicaid Services recently signed off on its first digital health reimbursement plan, which will reward providers for using remote monitoring and telehealth services.
But we are far behind our peers. Britain’s National Health Service has adopted a broad, government-sanctioned digital health strategy intended to integrate private sector innovation into public health.
Congress can play a leading role in this effort, finding funds for a new national institute dedicated to digital health innovation. Such an institute could fund research, convene stakeholders and provide regulatory guidance to the Food and Drug Administration regarding new technologies.
There’s so much else Congress could do that needn’t invite reflexive partisanship, such as reducing the unbearably high costs of end-of-life care, filling persistent gaps in palliative care services and improving research into novel forms of primary care that have shown initial promise.
Fixing our health care system should be rooted in common sense, not zealotry. For the Democratic candidates who will debate the next two nights, this is an opportunity to reverse the script. Minimize the talk of Medicare for all and instead push for creative solutions that are more realistic.
Let’s hope our leaders can agree to agree for a change.
Vinay Gupta (@VinGuptaMD) is an assistant professor of pulmonary and critical care medicine at the University of Washington and a major in the United States Air Force medical corps.
The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: [email protected].
Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.
Source: Read Full Article