Accountable Care Organizations, Value Based Purchasing, and Healthcare Exchanges – we are adrift in healthcare reform plans and strategies concurrent with a looming debt ceiling debacle. Amid the rhetoric, pundits, and industry leaders engaged in reform discourse, the cost of healthcare continues to spiral. Projects for 2011 cite the US government’s expenditure for healthcare will top 1 trillion dollars, or seven percent of the US gross domestic product.
Congressional Budget Office Director Douglas Elmendorf reported on 12 July 2011 that the cost of healthcare in the United States is increasing. The impact to employer sponsored healthcare plans therefore is becoming more unmanageable. In a speech top the U.S. Chamber of Commerce, he presented six options for employers trying to manage the growing crises.
One suggestion was to reduce the Medicaid expansion and mandated insurance subsidies. Other areas of potential cuts ranged from reversing financial assistance to increasing Medicare eligibility to 67 years. Underlying his comments was the incongruence of offering “nearly universal coverage” to American consumers without a revenue stream or non-monetary supports to mitigate the additional cost.
American access to healthcare continues to be limited based on an expanding economic divide between the classes. Healthcare providers are gearing up for an influx of heretofore consumers without coverage entering the system supported by some for of insurance coverage. Predictive models identify impact on physician office, emergency, and ambulatory care; minimal impact if forecasted to inpatient clinical services. This gearing-up of increased need for providers – physician, physician extender, hospital and ambulatory sites of care, includes physician employment, engagement, and affiliation. All of this is against a backdrop of promised revenues and financially unsupported access strategies.
The comments and recommendations from the CBO Director are not unfounded. The CBO is impartial and should not fall victim to one political perspective or another. These comments to the US Chamber of Commerce create doubt and fear rather than responsiveness and answers. Healthcare accessibility is a national priority or not. Just decide. We must stop raising hopes for a healthy population and then taking it back.
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