Health Reform in 2013

It is nothing new to hear that health reform is a very complex issue.  Whether its international health reform, national health reform or health reform at the community level, it will never be black and white. Nor will it have an easy or simple solution. Below I will explore just a few thoughts on health reform.

In order to have successful health reform I believe it is essential to have an informed public. Part of the reason health reform in the United States is having problems was the lack of knowledge the American people have about the law. In a Kaiser Family Foundation survey in March 2013 57% of the people surveyed believed that the ACA contained a public option. [1]This is three years after the law was enacted, after endless television and public debates, not to mention a Supreme Court hearing decision the bill.  That was a disturbingly high % of people to be wrong about such an important aspect of the bill. An informed public can make better decisions about not only their health, but also their political opinions.

Health industry networks are another important tool in producing effective health reform. Bringing together different players from the various aspects of the health field to one table when putting together health reform is crucial. Physicians, patients, pharmaceutical companies, insurance companies, government agencies, etc. need to have a voice. To the same end each voice should have equal weight. Unfortunately, certain organizations have lobbying efforts and cash to spend that others don’t. Reform such as the ACA showed that all voices that were brought together were not equal. One example is the pharmaceutical industry’s voice was much louder & carried more weight than other voices at the table.  Although it wasn’t a perfect coalition of forces the ACA did bring many players to the table for the first time when creating this legislation.

Improved and innovative technology is imperative to most successful health reform. For example electronic billing can save money and time for providers, insurance companies and the government. Lower administrative costs are usually a factor in reducing health costs. As we saw with technology can also inhibit the implementation process if it isn’t done correctly. This leads to spending more money, which defeats the original purpose. Technological advances are also obviously crucial to science and medicine.

Reform should be created from the ground up, not from the top down. Community health workers and leaders know what the people in their area need. They will also be the first line of defense when implementing any reforms. State and local health communities should be part of the process and the solution.

Lastly in order for governmental reform to work when dealing with the financial markets, the government needs to have some regulatory authority. As Michael Reich stated, “If the state s going to expand the role of market in the health sector, then it must paradoxically also expand the role of the state in regulating the market.”[2]  It isn’t enough to create a new market place you also need to regulate certain aspects of it so costs saving can almost guaranteed.

Health reform comes in many shapes and sizes. Hopefully as more reform takes place around the world we can get more data to help build the most effective reforms possible.

[1] “ Kaiser Health Tracking Poll”.  Kaiser Family 2013.

[2]  Reich M. “Reshaping the state from above, from within from below: implications for public health”.  Social Science & Medicine 54 (2002) 1669-1675.


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