An EPIC Solution For Health Care Reform: Part 4

At this point, we are three-quarters of the way through a four part series on an EPIC solution for health care reform. We’ve examined the issues of Evidence, Payment, and Incentives. But there is one absolutely critical pillar remaining – Choice.

Choices, choices, choices. It’s the American way, the way of a free marketplace. In order for any competitive market place to be effective, consumers must be able to find the best product for the best price, or the best product for the best outcome. They also need to have the decision-making capacity in order to select their desired product.

This should extend not only to purchasing a car or a house. It should be a foundation upon which health care is built.

In the US, you have countless choices for everything in life – except for health care. So how do we provide choices?

If we have some level of universal health coverage, patients could then have their choice of providers. They could select the provider that provides the best customer experience and outcome.

Effective health care reform will depend upon a patient having the power to choose their provider. This will require greater access to care with more well-trained direct access practitioners. Legalized monopolies and gatekeeper models will need to be abandoned in order to attain and promote true consumer access. The models of care delivery will have to change. The need for more direct access providers can be met now, and does not depend upon educational programs graduating more physicians.

Patients need to have access to data to make appropriate choices in their health care. Patients must be able to compare results and outcomes from hospitals, surgical centers, physicians, and other health care providers. What are we hiding here, people? There is currently no accountability, and providers continue to do what they do, regardless of the outcome or proposed clinical practice guideline. Patients should be able to access this information freely.

The goal of the provider should be to create a product that is worth buying – much like any other industry in the US. Ask the patient what a high quality health care product looks like. They will tell you that they want providers to listen to them. Give patients TIME. As they say, “If you listen to the patient, they will tell you what is wrong”. Medical errors would be reduced. Patients would be less apt to say “damn, that doctor never did listen to me, now it’s his fault that I was misdiagnosed”. This would have a favorable effect on medical liability – more so than tort reform. Fewer patients would be so apt to file lawsuits if they felt like they were getting the “face time” necessary to solve their problem. But when a physician spends a total of 18 minutes with the patient – and less than a minute of pure listening prior to interjecting – then you can see why patients would be unhappy with the current system.

If the patient has choices, many of our health care woes – cost and quality being two of them - will self-regulate. All of this will require a paradigm shift, yes, but it will also allow the best providers to thrive and the worst providers to search for other employment.

Summary: An EPIC solution to health care reform will require Evidence, Payment, Incentives, and Choices. Providing a patient with access to care, from a variety of qualified health care providers, at a reasonable cost to the patient, and with reasonable reimbursement to those providers that provide good outcomes, does not have to be considered “socialized medicine”. An EPIC model would foster competition, free enterprise, the development of a quality product with, yes, a focus on the patient’s needs at is core and with the patient’s outcome in mind.

It would be a true patient-centered health care system. Pretty simple, isn’t it? So what are we waiting for?

Photo credits: EpicFireworks