Breaking Resolutions

A Critical Look at Healthcare and Payment Affordable Care Act

As I write my final blog of 2011 on healthcare payment, a friend commented that I shouldn’t be so cynical. Therefore I have decided that my 2012 New Year’s resolution will be to be less cynical!

That said, I remain concerned about where healthcare payment seems to be heading. My concern revolves around the government taking a more dominate position in overall healthcare reimbursement. Most don’t realize that when you tally all government health programs, Medicare, Medicaid, veterans’ affairs, State Children’s Health Insurance Programs (SCHIP), and Indian affairs, 46% of healthcare in the United States currently is taxpayer funded! The operative question is: What do all these programs have in common? They are all financially insolvent, bloated with layer upon layer of bureaucracy and inefficiency.

A recent editorial in the Wall Street Journal (December 28, 2011) examines the government’s role in the Affordable Care Act (ACA). They quote the work done by Christopher Conover and Jerry Ellig of the Mercatus Center at George Mason University; this center examines all government rules costing more than $100 million and assigns a composite score. Conover and Ellig found that “the federal government used a fast-track process of regulatory analysis that failed to comply with its own standards, and produced poorly substantiated claims about the ACA’s benefits and costs.” They scored the rules at the highest 25 out of 60, at the lowest 13! They opine: “These are not merely bad grades. They are relative F’s on the regulatory curve — about 35 to 40% lower than averages for the other rules.” The article comments: “Little wonder for a law that contains the phrase ‘the Secretary shall’ 1,563 times.”

So where does all this leave us? As a healthcare provider, I applaud and agree with a focus on measurable quality outcomes and patient-centered care. As a reasonable taxpayer, I wonder if our government can accomplish this goal in a cost-effective manner. After all, isn’t that what they are asking (telling) us to do? Do more with less? Added patient value? Hmm, I wonder if they can hold themselves to the same standard. Unfortunately, based on their historical track record, I fear I already know the answer.

Call me cynical! Just remember most New Year’s resolutions are broken by February; I’m a bit ahead of the curve!

Happy New Year’s to all!!
Robert Provenzano, MD

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“Badly Written Rules: New Studies Show the Quality of Federal Regulation Is Plummeting.” Editorial. Wall Street Journal 28 Dec. 2011: 9. Read full article…

Breaking Resolutions
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