Why fight to be the last person on the sinking health care ship?

Why fight to be the last person on the sinking health care ship?

Health care delivery, from the context of the Patient Protection Affordable Care Act (PPACA, aka Obamacare), is foundering in a sea of uncertainty because our political appointees argue about who is going to be the last on on the ship and who is responsible for the extremely complex solution that must follow. In the mean time, health care delivery becomes more difficult to access, which exacerbates illnesses and medical treatment options.

The current health care system is collapsing under its own weight because the "lawyers" in Washington who drafted PPACA did not understand health care is a system, a complex adaptive system with chaotic behaviors. The PPACA was built by political appointees using grandiose absolute assumptions, which now have proven to be completely wrong. Yet, the Congress and Senate continue to argue among each other while health care is taking on water.

I offer a starting point which seems to be an agreeable perspective among my peers to start the process of advancing a new health care system. I offer starting with the failures of the current, and yes past health care systems. Before we "repeal and replace," I want to address how to eradicate system failures and return wasted dollars back to the consumers. The dollars saved by eliminating failures could be used to build out the type of health care system that would be recognized as best-in-class. A best-in-class health care system would also be capable of providing a secure method to discourage system failure before the failure became economically material.

To put things in perspective, the U. S. Gross Domestic Product (GDP) in 2015 was $17.95 trillion and U.S. National Health Expenditure Accounts (NHEA) amounted to $3.2 trillion or 17.8% of GDP. Health care spending grew 5.8% in 2015. Contained in the $3.2 trillion is wasteful spending on system failures, which seem to be overlooked by our elected officials in Washington DC. Estimates from academic research studies identify hundreds of billions of dollars wasted on system failures, which lack comprehensive oversight programs.

Below, I have identified the areas of failure that should be addressed before any new health care act is adopted. The money saved or costs averted by eliminating the failures can be redirected to improvement models and incentives for commercialization of advanced technologies that the US government lacks to monitor and correct system failures. Commercialization of some portions of this process also add dollars to GDP. Instead of growing government, create incentives for commercial industry to support health care. Who can argue with making the health care system more manageable, cost effective and simplified.

Failures of Current and Past Health Care Systems:

1. Failure to provide care: Health care delivery and health care coordination
2. Failure to Mandate Evidence Based Treatment: Over treatment, defensive medical practices, and end of life treatment
3. Failure to Reduce Administrative Complexities: Securing patient data, submitting insurance claims, reimbursement, pricing transparency of commonly used medical products, and tort reform
4. Failure to eliminate Fraud Waste and Abuse: False Claims, counterfeit or adulterated drugs, and medical products.

An estimate from one academic source places the amount of dollars wasted on failures between $558 and $910 billion for 2011. Imagine what it has grown to today. To be completely honest, this is not a US health care system problem. The truth is these failures are, in whole, or in part of the entire global health care system. I ask that we reach out to put elected officials in Washington D.C. and ask them to begin at a point of agreement and work outwards into the tougher areas of health care. Let us not wast time with political posturing, let us make America well again.

Before us now is certainly a fork in the road, one way will lead us back to patchwork politics and status quo. The opposite way will lead us into a process of system improvements and stronger purchasing power based on the elimination of waste. I want so very much to help with framing an improved health care structure. I will start by being that distant voice of reason and hope it grows. Please provide feedback to this article.

In the end we all win if we agree on starting a better process.