The Future of Health Care Delivery: Why It Must Change and How It Will Affect You, by Dr. Steven Schimpff
From the author, Dr. Stephen Schimpff on Medical Megatrends
Health care in the United States is a paradox. We have the most expensive, technologically advanced medicine in the world, Yet, even basic medical care is not uniformly available or it is much too expensive. Furthermore, the quality of care is all too often less than satisfactory and not nearly safe enough.
There are many disruptive, often transformational changes coming, which will further complicate matters for the average patient. These changes are being driven by an aging population, our adverse lifestyles and behaviors, an ever-increasing shortage of providers, our attitudes about the end of life (“Isn’t there one more treatment to try?” even when death is inevitable), and a nascent rise in consumerism (“The patient is no longer willing to be patient”). One of the most important changes is a shift from a focus on the treatment and prevention of acute illness (e.g., pneumonia, appendicitis, etc.) to chronic diseases (e.g., diabetes with complications, heart failure, and cancer), which often are lifelong once developed, difficult to manage, and very expensive to treat – yet, mostly preventable. There are also many misconceptions about what medical care delivery is and what it could and should be. For example, few people understand that true comprehensive healthcare delivery requires both an intensive focus on both diagnosing and treating diseases and injuries when they occur as well as an equally intense focus on health promotion and disease prevention. Furthermore, few in the general public understand that those with chronic illnesses require well coordinated care by a multi-disciplinary team.Healthcare reform legislation has been touted as offering us better care opportunities when, in fact, healthcare reform is not about healthcare; it is mostly about paying for medical care for the uninsured, eliminating some of the health insurance restrictions consumers face, and only somewhat about the rising costs of medical care or improved quality.
“The Future of Health Care Delivery” provides a clear, concise overview of the main features of our current medical care delivery system, the rapid changes occurring in its landscape, and offers specific recommendations for steps and initiatives that America needs to take to move from a healthcare system that is primarily geared towards treating acute illnesses and injury, to one that focuses on health promotion and disease prevention and does a better job of managing complex, chronic diseases.
It is clearly time for a different approach to healthcare in this country. We need a major overhaul of the entire system that realigns incentives and balances fundamental rights with corresponding responsibilities. To do this, however, requires disruptive and transformational changes in how we pay for medical care, how we fund preventive medicine and public health, how we manage medical information, how we incentivize and pay healthcare providers, how we incentivize ourselves to take better care of our health, and how we assure that everyone has both access to care and the means to pay for it.
It will mean reorganizing medical care so that the consumer is the decision-maker, just as in any other industry or profession-customer relationship. For example, having a high deductible insurance policy owned by the individual would return insurance to what it has been traditionally while cementing the professional relationship between doctor and patient – like any other professional contract where the individual is the client (compared to our current system where the insurer is the client of the employer or the government, the doctor is the client of the insurer and the patient is the client of no one.) There will be many barriers to success, but it can be done. Indeed, it must be done or else we will continue to be a country deficient in the care that everyone could and should have while we will continue spending more and more on a per capita basis for healthcare – much more than other countries with equal or better health quality measures.
Does this mean that huge new sums of money will need to be spent? No. There is plenty of money is in the system now; it is “just” a matter of reorganizing priorities so that it can be spent efficiently and effectively in a manner that will actually improve the quality of care while reducing its cost. All parties will need to accept responsibilities along with their rights, something that is not prevalent today. This will be a major task, for sure, but it is certainly not insurmountable.
The three key themes of the book are as follows:
- The disruptive and transformational changes coming and needed
- The clarification of misconceptions
- The balancing of rights with responsibilities – to lead us to a true healthcare system that functions for the benefit of all.
This book is designed to inform the average healthcare consumer as well as the healthcare policymaker about what works and what does not in our current medical care delivery system, how it is changing, and how each individual’s own actions can influence their health, the quality of their care, their healthcare costs, and their satisfaction with the healthcare they receive.