Strengthen Oba­macare, don’t re­peal it

Baltimore Sun - - WORLD - Dr. Scott A. Berkowitz, Bal­ti­more The writer is se­nior med­i­cal di­rec­tor of ac­count­able care for Johns Hop­kins Medicine.

With the very real is­sues that face Amer­i­cans to­day as well as the back­drop of a heated elec­tion sea­son, it can be dif­fi­cult to re­call the progress that has been made in re­cent years with re­spect to health care. Mil­lions more Amer­i­cans now have health cov­er­age, but be­yond that, huge gains have been made in the area of “de­liv­ery sys­tem re­form.” This refers to the way in which physi­cian groups, health sys­tems and oth­ers fo­cus on im­prov­ing the qual­ity and ef­fi­ciency of care that they pro­vide and many of th­ese op­por­tu­ni­ties have been made pos­si­ble by the Af­ford­able Care Act (ACA).

Th­ese ef­forts im­pact our pa­tients as well as our com­mu­ni­ties, and can en­list broad stake­holder groups in a process of col­lab­o­ra­tive change and learn­ing. For ex­am­ple, the Johns Hop­kins Com­mu­nity Heath Part­ner­ship (or J-CHiP pro­gram) sought to im­prove co­or­di­na­tion across care set­tings in East Bal­ti­more and was spon­sored by a fed­eral govern­ment award. Other pro­grams cre­ated by the state or pur­sued by health sys­tems or provider groups lever­age new ACA op­por­tu­ni­ties to bet­ter en­able de­liv­er­ing pa­tient-cen­tered care. Th­ese seeds of in­no­va­tion are try­ing to crack the code on how to im­prove health within the re­al­i­ties fac­ing lo­cal com­mu­ni­ties — where pro­jected life ex­pectancy can vary by decades from one neigh­bor­hood to the next.

Bi­par­ti­san so­lu­tions are both pos­si­ble and de­sir­able, but a health care plat­form fo­cused on re­peal­ing the ACA is a step in the wrong di­rec­tion (“The Oba­macare at­tack,” Nov. 3). As we move for­ward, let’s not lose sight of the ul­ti­mate con­stituent — all of us are pa­tients.

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