Tuesday, August 28, 2012

The Health Reform Gospel
Go ye into the entire world, and preach the gospel to every creature.
The Holy Bible: Matthew
August 28, 2012 - President Obama has remained strangely silent about Obama care’s virtues, perhaps because of its unpopularity, so it remains for others to bring his gospel to the masses.    One articulate spokesman for Obama’s health law is David Nash, MD, MBA, dean of the Jefferson School of Population Health in Philadelphia
Here, in an editorial in the summer 2012 issue of Prescriptions for Excellence in Health Care, a newsletter supported by E.L. Lilly USA, LLC, Nash explains why implementation of the law is needed now – to improve the health of the population and quality of care.
While I believe the consequences of Obamacare outweigh its benefits, it’s important to hear the other side of the argument.  These are selected excerpts from Nash’s editorial “Population Health and Health Reform – Inseparable Concepts.”
“With 45% of us suffering from at least 1 chronic condition and more than 49% million of us lacking health insurance, the need for a population health approach has never been more urgent.”
“Population health takes aim at some of the basic shortcomings in our traditional health care delivery system: namely, enhancing health and wellness through prevention and lifestyle changes, reducing and eliminated waste and errors, eradicating disparities, improving transparency and accountability, and improving care coordination – a goal shared with health reform.”
“How does  the Patient Protection and Affordable Care Act (ACA) incorporate the principles of population health?  First and foremost, it creates a new framework for health care delivery in the United States by adopting a comprehensive national strategy for quality improvements, the which is clinically integrated systems-based practices.  This should result in care that is coordinated across all diseases, providers, and care settings over time. Importantly, hospitals and health systems will be required to extend their quality oversight processes as they pose collaborative relationships with physician and other entities.”
The Accountable Car Organization (ACO) program, a prominent feature of the ACA, will have a major influence on extending quality oversight processes to putpatient settings, which is where Americans receive the overwhelming majority of their health care services.  A shared savings move, the ACO will require participating providers to use the tools of population-base care to achieve the cost savings necessary for success.”
The patient-centered medical home and ACO models that feature prominently in health reform contain aspects of care deliver that fall under the umbrella of population health.  These efforts and related new payment models are an attempt to identify and  eliminate inefficiencies in the system. “
“Rather than simply following the rules of reform, health care leaders must fully understand and follow the intricately  related tenets of population-based care as these will have a major influence.”
There you have it: the basic tenets of the Obamacare gospel.
This lofty rhetoric on Obamacare goals and difficulties of implementation  remind me of the story of the husband and wife watching their children play in the newly laid concrete in the sidewalk in front of their home.  The husband is livid with rage.  The wife says, “But Dear, I thought you loved children.”  He responded,” In the abstract, but not in  the concrete.”
Tweet: The goals of Obamacare – to improve the health of the American population and to impove its quality- are admirable, but hard to implement.

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