Who’ll be the sav­ior?

Modern Healthcare - - Opinions Letters -

As a health­care ex­ec­u­tive for more than 35 years, I was struck by the many chal­lenges fac­ing our in­dus­try as detailed in the sto­ries in the April 5 is­sue. While the cover head­line talked about “For-profit sav­iors?” I won­dered who was go­ing to be the “sav­ior” for the myr­iad of new chal­lenges. It seems, from read­ing all of the sto­ries, that we have many prob­lems with few so­lu­tions, and fewer “sav­iors” who can iden­tify so­lu­tions and even fewer who can im­ple­ment them.

Look at the list of chal­lenges:

Cre­at­ing tem­po­rary high-risk pools for the unin­sured in the states.

Flawed CMS over­sight of the re­cov­ery au­dit con­trac­tor process. Not-for-prof­its’ cap­i­tal cri­sis. Not-for-profit merg­ers stalled—they need to start looking out five to 10 years at a time when no one can pre­dict the im­pact of all the changes in the next two years.

No one at the lead­er­ship helm at the CMS at a time of enor­mous change, new re­spon­si­bil­i­ties and im­ple­men­ta­tion of the health­care bill.

Ac­count­able-care pay mod­els not set, af­ter years of study. Ari­zona has been talk­ing about set­ting a sys­tem up for a year with no res­o­lu­tion.

Em­ploy­ers to be sad­dled with lots more pa­per­work un­der health­care re­form.

In­abil­ity of Congress to re­solve the sus­tain­able growth-rate for­mula at a time they need all hands on deck to care for 32 mil­lion more pa­tients, and more and more physi­cians drop­ping out of Medi­care or lim­it­ing the num­ber of Medi­care and Med­i­caid pa­tients they will see in their prac­tices.

Con­flict on who has au­thor­ity to reg­u­late scan­ning and imag­ing safety.

The Fed­eral Com­mu­ni­ca­tions Com­mis­sion’s broad­band wireless plan and crossjuris­dic­tion is­sues—who is lead­ing the ef­fort?

The in­dus­try’s best cus­tomers (in­sur­ance plans) be­ing de­mo­nized.

Opin­ion leaders go­ing ev­ery which way about health re­form—most are for it, but most don’t think it is go­ing to work very well—state re­sis­tance, not enough pri­mary-care physi­cians, physi­cian pay­ment not enough, etc.

Dis­pute among physi­cians, nurse prac­ti­tion­ers, ex­ten­ders, etc., over the scope of prac­tice au­thor­ity, role in care, etc., all at a time when we will need many more prac­ti­tion­ers.

All of this in just one is­sue of Mod­ern Health­care. Th­ese are com­plex, se­ri­ous is­sues. Where is the over­all lead­er­ship com­ing from that can de­velop a com­pre­hen­sive ap­proach to re­solv­ing the myr­iad chal­lenges to pro­vid­ing high­qual­ity med­i­cal care to our en­tire pop­u­la­tion? I just wish I had even the glim­mer of an an­swer. Thomas H. Hansen

Con­sul­tant Scotts­dale, Ariz., and Oak Park, Ill.

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