The Final State of the Union
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Summary:
here are millions of health insurance horror stories across the country, and while very few can be summed up in just a few minutes, the responses we’ve gotten to Vice Pre
There are millions of health insurance horror stories across the country, and while very few can be summed up in just a few minutes, the responses we’ve gotten to Vice President Biden’s call for videos on why reform matters to you have revealed a snapshot of what Americans go through every day.
The response below hints at a fundamental matter of incentives:
This is actually an issue that President Obama has emphasized himself repeatedly, including in a major speech to the American Medical Association in Chicago (the whole speech is well worth watching, click through the link to see it):
There are two main reasons for this. The first is a system of incentives where the more tests and services are provided, the more money we pay. And a lot of people in this room know what I'm talking about. It's a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can't spend much time with each, and gives you every incentive to order that extra MRI or EKG, even if it's not necessary. It's a model that has taken the pursuit of medicine from a profession -- a calling -- to a business.
That's not why you became doctors. That's not why you put in all those hours in the Anatomy Suite or the O.R. That's not what brings you back to a patient's bedside to check in, or makes you call a loved one of a patient to say it will be fine. You didn't enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers. (Applause.) And that's what our health care system should let you be. That's what this health care system should let you be. (Applause.)
Now, that starts with reforming the way we compensate our providers -- doctors and hospitals. We need to bundle payments so you aren't paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead paid well for how you treat the overall disease. We need to create incentives for physicians to team up, because we know that when that happens, it results in a healthier patient. We need to give doctors bonuses for good health outcomes, so we're not promoting just more treatment, but better care.
