I see that Ezekiel Emanuel MD is advising the White House Budget Director Peter Orszag. This is a very good thing as Dr. Emanuel is a brilliant thinker on how we might reform the way America purchases health care.
Zeke – please tell me that there is more to the White House plan than just moving us toward universal coverage. I’m totally in favor of universal coverage, it’s just that without changing how the money flows inside health care or changing the way we work in health care, we’re just going to add immensely to the expense of health care.
Orszag rightly identifies health care reform as a necessary step in fixing the economy in the US, but the fix has got to be based on more than “HIT” and “more focus on prevention.” Again – I’m not against either: good HIT (matched with changing the way we work) leads to significant benefit.
If we are ever going to have anything like a high performing health system that improves outcomes, improves the experience of care, and at a cost we can afford, we MUST reform the way health care dollars flow in the system and we MUST reform the way we deliver care.
I don't yet see any serious discussion on these points.
L. Gordon Moore MD
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