Health Reform WK-EDGE Stop wasting $1T/year, change health care payment
Tuesday, March 13, 2018

Stop wasting $1T/year, change health care payment

By Bryant Storm, J.D.

The government should eliminate fee-for-service in the federal health care programs to help cut more than $1 trillion in annual, wasteful health care spending, according to a report from the Texas Medical Center Health Policy Institute. The report made this and other recommendations designed to address a costly and unsustainable health care system which is estimated to have spent $10,000 on health care for every man, woman, and child in 2016. The report reproves current debates over health care for focusing on the costs of government-supported insurance without considering the costs of care, itself—experts consider as much as one-third of U.S. health expenditure to be waste.

Recommendations. The Texas Medical Center Health Policy Institute convened a group of experts to develop recommendations to alleviate the wasteful spending. Those recommendations include:

  • Allow the government to use cost and cost-effectiveness in decision-making
  • Eliminate fee-for-service
  • Standardize quality-of-care metrics
  • Empower patients to be responsible for their own health and health care
  • Improve care coordination through task shifting
  • Reduce emergency department utilization and readmissions
  • Develop more specific approaches to improving end-of-life care
  • Meaningfully address the impacts of adverse childhood experiences

ACA. The report also challenges the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), noting that while the health law brought coverage to an additional 20 million individuals, around 10 percent of the non-elderly population remains without health insurance. Additionally, the report notes that the ACA failed to address the issue of high cost deductibles, which rise as high as $6000 for many individuals and remain a barrier to coverage. The Texas Medical Center Health Policy Institute also challenged the ACA’s restriction which prevents the federal government from using the cost of care, as well as information about the cost-effectiveness of care, in Medicare coverage decisions. The report recommends that lawmakers look the United Kingdom and its National Institute for Health and Care Excellence (NICE), a non-governmental body which uses cost prominently in its analyses.

Companies: Texas Medical Center Health Policy Institute

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