Insights on American Health Care Challenges and Solutions
Insights from Arthur (Tim) Garson, Jr., MD, MPH, shed light on the challenges and opportunities in the American health care system. Key points include lessons learned from the ACHA, the need to address health care costs, the impact of Medicaid cuts, and strategies for both parties to collaborate on cost-cutting measures.
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TexasCare ACT AND BEYOND THE AMERICAN HEALTH CARE Arthur (Tim) Garson, Jr., MD, MPH Director TMC Health Policy Institute TMC GOVERNMENT AFFAIRS COUNCIL June 6, 2017
What did we learn from the ACHA? 1. Almost all Republican members of the House would have voted for: Obamacare $190 bn to $30 bn 23 million lose coverage The tax credit discussion seemed unrelated to trying to make coverage affordable ($2,000-$4,000) 5% of income for $30,000 (barber/hairdresser) = $1,500 ACHA would require to pay an additional $2500 per year (total 13% of income) Eliminates mandates replace with 30% fine
What did we learn from the ACHA? 2. Few spoke out to save the huge cuts to Medicaid 48% of those covered by Medicaid expansion permanently disabled Of the other half 62% already working or in school 3. Original CBO $337 bn reduction in deficit Last minute chopped this in half ($119 bn) little argument 4. Requirements for what should be in health plans (e.g. maternity) thrown out Watch for the plans to emerge so riddled with gotchas they wont come close to covering expenses like $1,000 in hospital costs/year [Consumer Reports]
Its the cost, stupid! We waste 1/3 of our health care dollars Failures of care delivery $128 billion Failures of care coordination Overtreatment $35 billion $192 billion Administrative complexity $248 billion Pricing failures $131 billion Fraud and abuse $177 billion TOTAL $910 billion Berwick, JAMA, 2012
Both parties can win if we cut health care costs 1. Salary physicians ($192 bn) Mayo, Cleveland Clinic, Kaiser Permanente 2. Permit Medicare to consider cost 3. Low-deductible catastrophic plan ( major medical ) 4. Efficiencies in Medicaid consider mandates 5. Patients incentives to do their share Coaches Diabetes Prudent buyers information at the correct education level
