Healthcare reform is all about money!
Healthcare reform is all about money. Most of the discussion happening is around the reform to Healthcare Insurance. The various provisions that are discussed today like universal coverage, removal of restrictions on pre-existing conditions, electronic health records, Health Information exchanges etc are going to increase the cost that is currently borne by the members and the employers. Even without these changes, we are seeing the healthcare costs going up on an annual basis and it has increased consistently and alarmingly in the past 15 years. We have seen employers reduce their share of the expenses as the total price keeps going up. This trend is going to continue. When you talk about removing pre-existing conditions restriction that currently exists or allowing even chronically ill patients to be able to buy affordable (?) health insurance, it sounds great. But what does this mean to the health care costs? This definitely is going to increase the cost burden on the Insurers. So who gets to pay for this additional expense? Of course the member! Or let us consider the scenario where there is a competing government health plan option. Where does the government get the money from to pay for covering everyone? Again the members, who are the tax payers will get to pay for it. So is having Universal coverage not a good thing? Definitely not! So what do we need to focus on? Definitely the most efficient and cost effective way to provide the coverage to everyone. And that means the focus should be on efficiency and eliminating wastage and reduction in errors.
Also another important concept that everyone should focus on is prevention and wellness. It is always better not to get sick at all instead of trying to fix once you get sick. We have seen a lot of focus on wellness recently compared to disease management. Well, that is easier said than done. This requires a major change management in the way we live our lives. A lot has to do with how we eat and exercise. When I visited China, I saw a lot of people during dawn and dusk on the roads and public parks doing various physical exercises from Tai chi to Karate and even ball room dancing! They were in groups of 20 or more and they do this on a regular basis. I think it is a cultural thing. In China I don’t seeing too many people who are obese. Maybe this daily exercise helps in keeping them healthy.
In Singapore, elementary school kids get to run a few extra laps around the school playground because they are a couple of pounds overweight with respect to the WHO guidelines. I felt really angry when I first heard about the thought of a six year old I would consider to be of normal weight being subjected to this kind of treatment in school. But on second thoughts, I think it is a good idea to instill the value of good healthy living in kids when they are really young. If you get used to such good practices as a young kid, you will tend to stick to it later in life too. That is wellness management in action!
