While it remains true that many Americans are uninsured or underinsured, the solution is not as simple as “universal care for free.” Free enterprise and free health care are difficult to blend.
The solution requires cost control, government policies that support patient choice and electronic access to medical record information.
If the pieces of the health-care puzzle independently controlled their costs, the whole system would benefit. Ambulatory surgery centers (ASCs) are a perfect model to look at as we consider restructuring health care.
ASCs provide high-quality, efficient care at a reduced rate. They are reimbursed 59 percent of what hospitals are reimbursed for the same procedure. Patients need to consider what site is the best facility for the services required. A Medicare patient’s co-pay for a cataract at a hospital is $495.96; the co-pay for the same procedure at an ASC is only $192.94. Insurance companies, Medicare and patients all save money when patients choose ASCs.
Patients who choose to have the surgery they need in ASCs also benefit from the top-notch patient care and customer service they receive there. In fact, many patients who have surgery in an ASC say they never want to go anywhere else if they ever need surgery again.
One way the federal government could help patients make wise choices about where they receive care is to collect and publish comparable data from various surgery providers that patients could understand and compare easily.
Finally, a National Electronic Medical Record Software program that would allow all health-care providers to access radiological, laboratory tests, all prior medical records, as well as medication reconciliation to coordinate patient care would be one of the most useful improvements that could be coordinated at a national level.
The present system with several different mismatched products resembles the Tower of Babel. The piecemeal implementation is costly and hinders quality care while failing to increase efficiency.