Brawner: Obamacare Decision Won’t End Health Care Debate

Arkansas News Bureau columnist Steve Brawner examines the trajectory of the nation’s health care system through the lens of the U.S. Supreme Court challenge of the new federal health care law.

As Brawner notes, regardless of the high court’s decision, the health care debate will roll on for a variety of reasons.  One of the most notable reasons: health care costs can’t sustain their current course.

Writes Brawner:

That which is unsustainable eventually ends. If you are headed toward a cliff, you either stop, turn left or right, put it in reverse, or plummet over the side. But one way or the other, you eventually no longer will be heading toward that cliff.

Regardless of what the Supreme Court decides, changes are coming to health care — some as a result of government action, some as a result of the private sector doing what it must to make a profit.

One way the system will change is in the payment method because the current system does not have enough incentives to control costs. Doctors and hospitals are paid not to cure patients, or to prevent them from getting sick, but to treat them, and they live in fear of being sued if they don’t. That doesn’t mean they don’t try to do their best, but it does result in the system being oriented around very expensive “treatment” with very expensive medical equipment rather than health.

You can’t fix health care until you address those incentives. In the near future, revenue streams will be created that pay for preventive care, so get ready for phone calls from our medical clinics asking if we have taken our high blood pressure pills. The state’s Medicaid program, meanwhile, is experimenting with a payment method known as “bundling,” where Medicaid simply writes one big check for an “episode of care,” such as an appendectomy. It’s up to the hospital or medical provider to perform the procedure effectively and disburse the money while still making a profit.

Some of this will be very controversial. The very nature of saving money is that somebody will get less of it. So regardless of what the Supreme Court decides on Obamacare, we’ll have plenty to argue about in order to fix a health care system that has saved many lives but can’t sustain itself.

You can read Brawner’s full column at this link to the Arkansas News Bureau.