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Healthcare Reform: Is Access Enough? – Part 3

Healthcare Reform:

Be Careful What You Wish For

pile of bodies from medical mistakesRead Part 1Read Part 2

Healthcare reform in America is driven largely by the estimate that 44,000 Americans die every year due to lack of health insurance.

Appalling as that number is, it pales in comparison to the carnage – largely concealed and unrecognized by the public – of those dying from medical mistakes every year. These are those who did access the healthcare system.

This is largely unappreciated because it’s so under-reported by doctors and hospitals.

Both political extremes are therefore oblivious. And that’s why neither extreme’s solutions are of much help.

Both fail to recognize, much less correct, our dual crises of medical misspending and treatment injury.

As a result, it’s likely that tens of thousands more Americans will die every year from medical negligence due to their increased access to our broken healthcare system.

That’s the difference between health insurance reform and actual healthcare reform. And it’s a fatal distinction.

Illusory Savings

Nor is medical spending likely to be brought under control by health reform.  Again, we can look to the Massachusetts precedent.

A report in mid-2011 by the state Attorney General’s office was sobering in its conclusions. It found initial efforts to cut costs by converting to “global” payment systems planned under health reform failed to save money.

Even worse, they’ve substantially increased spending. Annual spending in “global” payment systems increased by 10% from 2008 to 2009 vs. a 1.7% increase for those in the standard payment system.

Health reform nationally hopes to achieve a slowdown in medical spending growth – not the same as cutting medical spending – by relying largely on this approach.

medical provider networks can increase medical pricingThe problem is the Accountable Care Organizations (ACOs) encouraged under health reform to better coordinate care and slow spending growth require large-scale provider networks.

This means more consolidation among doctors, hospitals, and even insurers. That’s because of the critical mass needed to assume the financial risk “global payments” impose on doctors and hospitals.

This greater size gives these expanded provider networks more negotiating clout with insurers. This, in turn, allows them to selectively price gouge based on their greater  market clout.

That’s exactly what’s happened in Massachusetts since the merger of its medical powerhouses. And it’s largely responsible for its accelerated medical spending.

Market purists might consider this “the free market at work”. But a formula for cutting medical spending – and avoiding financial disaster – it is not.

A Different Take on Health Reform

We’d prefer to ignore health reform rather than contribute to its power to further distract you. Because what you need to do to avoid this medical tsunami has nothing to do with your politics.

But it’s too fundamental to our near-term medical futures to ignore.

Our take on it, however, is unlikely to be what you’ll find in the mainstream media. Or anywhere else.

They’re all likely to continue to buy into the false paradigm of improving access to our healthcare system.

The problem for most Americans. however, is too EASY access to a broken medical system that’s ill-equipped to treat our growing epidemics of chronic diseases. These account for most of our medical spending – and most of our medical injuries.

This treatment failure compounds our out-of-control medical spending – 75% of it on chronic disease care.

It also compounds the rampant neglect of patient safety and poor medical performance. According to the Commonwealth Fund Scorecard*, only half the patients in America are receiving basic preventive healthcare services.

The real-world consequences of our failure to confront such medical incompetence and the routine deceit behind our exploding medical costs are too crucial to rely on traditional media sources. Their own timidity matches that of our government. Neither is doing its job very well.

For more of this beyond-the-politics view of things, you’ll have to stay here.

And there is more to come.

In addition to blog posts you’ll find here at, our book on health reform is being edited and will be published later this year. That’s where we’ll get into the real nitty-gritty of health reform.

In the meantime, enjoy the appetizers that appear here. Because the main course will be  a doozy.

* Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011. October 18, 2011.

This article is provided for informational and educational purposes only.
It does not constitute medical advice and should not be relied upon as such.

Click the book cover below for instant access to the FREE Introduction chapter to
Our Healthcare Sucks

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