Consumers continue to take on a greater role in paying for healthcare services through copayments, deductibles and premiums and help fund the U.S. healthcare system through federal income taxes. As the healthcare industry moves away from fee-for-service to value-based care, healthcare expert Paul Keckley, Ph.D., says the federal government will have the address four high-stakes issues in response to rising costs.
The United States outflanks several other developed countries in health expenditures as percentage of gross domestic product (GDP), with 17.7 percent, far ahead of the runner-up, France, with 11.6 percent, writes Keckley, managing director at the Navigant Center for Healthcare Research and Policy Analysis, in Pulse Weekly. His column examines the role the federal government plays in healthcare and suggests lawmakers tackle:
Structure: To integrate systems of care in such a way that they can bear clinical and financial risk, the government must move beyond the idea of healthcare oversight as a local or state issue. "The federal government must weigh in on healthcare's version of 'too big to fail' while recognizing that much of what's done today is 'too small to scale,'" Keckley writes.
Incentives: To ensure a smooth transition from volume-based care to a value-based model, Keckley writes, healthcare needs policies that provide incentives for innovation in diagnosis, delivery and outcomes, and link delivery to results and processes over scope of practice.
Employers: The long-term desirability of the employer-based insurance system remains a matter of some controversy, Keckley writes, and either way federal policy has a major role to play, especially as Affordable Care Act penalties for not providing employee coverage kick in.
Consumers: As healthcare remains manufacturer-controlled, costs are buried in non-transparent pricing, and hospital staff often does not tell patients the price of procedures, nor are desirable outcomes always clearly defined or readily available. These features, Keckley writes, indicate the industry might be better served by a one-size-fits-all central government model or a retail market.
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