Healthcare Reform Won’t Come From Within
America’s doctors are being exhorted to assume healthcare reform leadership roles in expediting payment reforms and system transparency.
In considering why I find this so unlikely, I remembered a tactless comment I made back in my days as a regional health planner when presenting my case to a state regulatory board.
In the midst of my presentation, I said something about getting a group of doctors to agree on something – anything, really – was like herding cats. The sole doctor on the board responded that he agreed with my presentation but wished I hadn’t made the herding cats comment. Of course, I immediately responded “So do I” and we all had a good chuckle.
But there’s continuing relevance in the medical profession’s history of stubborn non-conformity, especially as calls are made anew to enlist their collective leadership in making healthcare reform more effective – whether in implementing Obamacare’s components or beyond.
The Good Doctors Weigh In
Dr. Zeke Emanuel – a major architect of Obamacare – and Dr. Donald Berwick, former head of Medicare and Medicaid at the federal level, have both gone on record to encourage their physician audiences to take up the cudgel of healthcare reform.
This is likely to prove as effective as President Obama lecturing the NRA about their need to be reasonable in accepting prudent gun control measures.
Consider, for example, the list of vital healthcare reform ingredients Dr. Emmanuel laid out to his physician audience as reported by MedPage Today:
“‘We need to take the responsibility now as a group in pushing for payment change,’ Emanuel said. ‘It’s the only way we can facilitate the transformation and re-engineering that the system needs and we need to care about.’…
“He called on physicians to ‘get our house in order’ and ‘collectively campaign’ for these changes…
“If physicians take the lead, they can enhance their autonomy and design the delivery system they want, but that system will also assign them financial risk…
“‘I see no way of getting out of that,’ he warned. ‘It’s not a dilemma. It’s just the inherent nature of what it means to assume autonomy.’…
“Emanuel highlighted six elements that must underline payment and delivery reform efforts:
Focus on cost value
Focus on the patient
Work in clinical teams, not as individuals
Reorganize delivery systems
Ensure price and quality transparency