Replacing Obamacare with Real Health Care Reform — NEJM
Mark Dimor
Wayne Caswell
Thanks, Mark. Below is the comment I added.
SUBJECT: The key to health reform is getting the incentives right.
ACA helps fix a “sick care” system that’s profoundly broken and has perverse incentives to view patients as paying customers, treat symptoms, and pay practitioners for each test, drug and procedure. ACA, with its emphasis on positive outcomes and overall health, wellness & prevention, helps minimize the need for medical care in the first place, thus reducing costs and maintaining a healthy & productive workforce that contributes to a vibrant economy.
Much public debate, with viewpoints from many stakeholders, went into developing the ACA, and even if more work is needed, it's a good start. Repealing it is *not* the answer. The key is getting the incentives right and capitalizing on the contrasting incentives of public & private entities. Private companies measure success in terms of Profit, ROI, Payback Period, Stock Price, etc. Public entities measure success differently and over much longer time periods, so they can make more strategic and longer-term investments and fund them with bonds and tax revenues. With no profit motive, the public sector can sometimes be more cost effective.
For more on this, see http://www.mhealthtalk.com/2012/08/hybrid-model/.
Also see the Obama perspective at http://www.nejm.org/doi/full/10.1056/NEJMp1211514/.
Wayne Caswell
Founder & Senior Editor, Modern Health Talk
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Wayne Caswell
Sorry for replying to the Group instead of to Mark personally.
Wayne