A recent article in the New England Journal of Medicine disects how “market friendly” ACA (or Obamacare) and its impact on the US healthcare system. The entire NEJM article can be read here.
Dr. Vernon Rowe, founder and medical director of The Rowe Neurlogy Institute, felt compelled to respond to this article in the NEJM to shed light on the ACA’s implications for patients as well as outpatient physicians:
This is a profound article. It strikes at the heart of the main reasons for escalating health care cost, the main one of which is our institutional and hospital-based system of care. This system is growing ever stronger by the day with the legal purchase of primary care practices, stifling any possibility of market forces operating in healthcare.
“…but they fundamentally misunderstand what it takes to be market-friendly… What is needed are reforms that create clear financial incentives that promote value over volume, with active engagement by both consumers and the health care sector. Market-friendly reforms require empowering individuals, armed with good information and non-distorting subsidies, to choose the type of Medicare delivery system they want.”
Fortunately, this has not escaped the attention of MedPAC, the body which advises congress. It is now obvious to the people on this panel that hospital-owned care (even for the same procedure in the same office) is vastly more expensive than “real” outpatient care for the same diagnosis.
“Unless these institutions find ways to reduce costs, lower Medicare reimbursements will force providers to bargain for higher payments from private insurers. And eventually, seniors’ access to services will be threatened.”
So keep the hospitals out of the outpatient care market. When physicians employed by hospitals recommend testing or surgery, require that those physicians make patients aware oflower cost options in the non-institutionalized sector. Make Medicare and Medicaid beneficiaries aware that there are lower-cost options available for the limited healthcare dollars (voucher or otherwise) that they spend. And fund the Public Health Departments for preventive medical care for the poor. It’s really pretty simple.
