Creating a smarter system

Republicans on Capitol Hill, emboldened by their election gains, keep talking about repealing the health-care reform law passed earlier this year, even though they must know it won’t happen — not in the next two years, at any rate. Democrats will still hold a majority in the Senate come January, and a Democratic president who spent all his political capital to get health-care reform passed would veto any bill that undid it, anyway.

One of the most repeated GOP talking points during the campaign was that the new law threatened Medicare by cutting its funding.

(The inherent contradiction in opposing “government-run health care” while attacking cost-saving reforms to existing government-run health care is remarkable. But we digress.)

In fact, the new law will launch the most serious efforts ever made to replace the most wasteful, inefficient aspects of Medicare — a payment system that rewards physicians for the number of procedures they perform, regardless of their redundancy or effectiveness. A new “value-based index,” written into the law by Washington Sen. Maria Cantwell, will encourage quality rather than quantity.

Because of its sheer size and scope, as goes Medicare, so goes the rest of the health-care system. Efficiencies gained there should spread, saving money and improving quality for all.

Cantwell’s involvement was no accident. The Puget Sound region has long been a leader in innovative approaches that save health-care dollars, particularly by coordinating patient care through a primary physician. Washington’s history of cost-effective care delivery is why providers here are reimbursed by Medicare at a lower rate than providers in other states. The value-based approach should begin to rectify that injustice.

Not surprisingly, the Puget Sound health-care community is already ahead of pending government reforms. A recent example is last month’s announcement of a new affilation between The Everett Clinic and Group Health Cooperative.

Each organization is an established leader in innovative approaches that emphasize coordinated care to improve outcomes and control costs. They already share important core values, and now will share expertise. Working together in a number of ways, they’ll learn from and complement each other. Their successes can serve as models for providers and insurers across the country, and even help guide some government reforms.

The wasteful cost structure of health care in the United States must change, dramatically. Our economic survival depends on it. With the private and public sectors both working to make Medicare more efficient and cost-effective, the prognosis is improving.  Turning back is no solution.

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