Last week, the new Health and Human Services (HHS) Secretary, Alex Azar, said, “Change is possible, change is necessary, and change is coming.” I hope so. Change is desperately needed. It remains to be seen if the federal government can make the changes needed and make them fast enough. The biggest barrier is Congress. HHS tried to simplify drug insurance last year, and Congress blocked the simplification because it would have been negative for the health insurance industry, one of the powerful lobbies that fuels Congress with donations.
Azar had other encouraging comments. He said one of the key commitments of the administration is to see the private sector as partners, not just entities to be regulated or overseen. He said HHS sees stakeholders as part of the solution to our country’s many healthcare challenges. The most important thing he said as part of the recent address was, “We’re unafraid of disrupting existing arrangements just because they are [controlled by] powerful special interests.”
Medical science has advanced rapidly, but innovation in payment and delivery systems has been slow. While Blockbuster put local video shops out of business and then Netflix put Blockbuster out of business, the healthcare system of care delivery and administration changed very little. The cost of Medicare healthcare has grown from $400 billion in 2001 to $1.2 trillion, but quality has not grown at the same rate.
Azar outlined four priorities for HHS:
- Giving consumers greater control of their healthcare records through health information technology
- Making healthcare pricing more transparent
- Using experimental models in Medicare and Medicaid
- Removing government burdens which impede the transformation to value-based healthcare
Electronic Health Records (EHRs) have the potential to lower cost and improve quality, but so far they have mostly frustrated patients and providers. They have outdated and awkward interfaces for doctors and are nearly unusable by patients. I am fortunate to live in two states. I am currently in Florida. I saw a doctor who ordered a routine test. The test was performed at a different hospital than the one who employs the doctor. The only way he can get the results is by fax. Paper. I asked for a copy of the results. I waited while a nurse took the time to make a copy of the pages. I don’t even have to ask about getting the results into my EHR in Connecticut. Fax is the only way. This despite $35 billion spent by the government for incentives for providers to implement EHRs, which were supposed to be interoperable. Contrast this with searching Amazon’s selection of 100+ million items, clicking once, and having the item on your doorstep in a day or two. I am hopeful Apple and Amazon will shake up the EHR industry.
I’ll have more to say about pricing transparency and value-based healthcare in later posts. See full article about Mr. Azar’s comments here. Read more about healthcare in Health Attitude: Unraveling and Solving the Complexities of Healthcare.
