In a recent evaluation of current health care reform proposals, Harvard Medical School dean Jeffrey FIier, MD Dean of Harvard Medical School gave “a failing grade” to recent policy efforts because the discussion has left out the people who actually care about health.
As a result, Dr. Flier asserted that “the speeches and news reports that have lead Americans to believe congressional legislation will solve the problems of cost, access and quality, are not true.”
He explained that our current health care system suffers from a “tax policy that drives employment-based insurance, which results in overinsurance and drives costs upward while creating inequities for the unemployed and self-employed.” He also noted the limitations to healthcare that are created by “a regulatory morass that limits innovation, and the deep flaws in Medicare and Medicaid that drive spending without optimizing care.”
The reason these speeches and reports are not true, according to Dr. Flier, is because “while the various bills give more access to health care by expanding Medicaid and mandating subsidized insurance at substantial cost … there are no provisions to substantively control the growth of costs or raise the quality of care.” Since no provisions address these critical issues, “the overall effort will fail to qualify as reform.”
He also noted that “dozens of health-care leaders and economists he has spoken with find near unanimity that whatever reform is passed will markedly accelerate national health-care spending rather than restrain it, and it will do little or nothing to improve quality or change health-care's dysfunctional delivery system.”
Instead, Dr. Flier asserted that “currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.” Current reform also threatens physicians and health care entities’ “capacity to innovate and develop new therapies.”
From his own firsthand experience, Dr. Flier has seen these results in Massachusetts, where although “insurance mandates similar to those proposed in the federal legislation succeeded in expanding coverage, they also increased total spending.” Accordingly, a new Commission in Massachusetts will have to be created in the future to reduce payments, which will “limit the dollars spent per patient for all of their care.”
With such “unclear and unspecified changes that would impact physician practices and compensation,” Dr. Flier concluded that “we should not be making public policy in such a crucial area by keeping the electorate ignorant of the actual road ahead.”