Will Politics or the Movement for Transforming Healthcare in America Prevail in 2014?

by Patrick Riley 16 Aug 2013
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Dr. Don Berwick, the father of The Triple Aim solution for healthcare, scolded industry leaders last week to "not focus solely on profit" as a cure all for healthcare in America. He suggested that his formula for controlling per capita costs, increasing access, and improving quality outcomes may be missing an ideological socio-economic foundation, that being, fiscal responsibility. Perhaps, even a moral responsibility to find a common ground for holding back escalating health industry costs, which we seem to be doing as of late, without the singular narrative of boosting operating margins, at the expense of the quality of our delivery system.

Meanwhile, Washington, under the direction of the Obama administration keeps the course set for established hard dates for implementation of the tenets of the Affordable Care Act. On the immediate horizon is the creation and flip of the ignition switch for health insurance marketplaces, or exchanges, set to go live on October 1st. HHS has announced it is spending $67 million in the 34 states it has the responsibility for establishing and running these very same entities in assisting the "navigation" for online browsers looking to enroll in health insurance. Seems to be a bit of an admission some the majority of us will get lost somehow in the process.

Lawmakers are grappling with budget funding votes hinting that passing an operating budget for FY 2014 must "de-fund" Obamacare" or face government default. This sounds like a sequel to a B movie from a couple of years ago. Yet, this discourse is dominating Congress at the moment, which means Sunday talk-shows will do the same, and FOX News and MSNBC will be spinning the story to suit their own political persuasions.

So, the issue before us is that 2014, like it or not, will be a historical year for healthcare in America, and around the world. There is much momentum in accountable care, its philosophy and ramifications, which, to date, have been for the most part very encouraging. Yet, politics is the concrete shoes healthcare transformation must wear into the deep end of the pool. If momentum can be maintained and lust for profit and power abates, we can achieve a great deal this coming year. If we cannot keep our head above water when it comes to the deep end and lose an ability to move forward because of the political debate, we will have lost a unique moment in history to do good.

By the way, Dr. Berwick is running to be Governor of Massachusetts. Albert Schweitzer has chosen to morh into Tip O'Neill.

I will continue to write and debate the great spectacle that is American healthcare, its politics, and impact on the healhcare continuum. You can follow me on @Patrick_FrostHC.

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