Many are wondering with the Supreme Court decision where do we go from here. The answer is, full steam ahead. All those states who put off forming health insurance exchanges, the clock is ticking, 2014 is just around the corner. For those states wondering what to do with the additional funds for Medicaid they have a choice, leave it alone, if the administrative cost is too large or go for it. The Centers for Medicare and Medicaid Services (CMS) has hundreds of regulations to write and projects to get going.
The court decided that the mandate was a tax, that being said, the President will have to figure out how to sell his tax to his constituents after promising “not to raise taxes on those making less than $250,000 per year.” This is not the first stop in the road, but an important one.
Healthcare insurance is expensive and we have to come up with ways to get the costs of care down. This is where continuing medical education comes into play. We need the best trained smartest healthcare force there is. If we are going to have efficiencies in the system to take care of the estimated 32,000,000 patients (more people than Canada), then we will need to devote significant resources into to educating healthcare extenders, nurse practitioners, physician assistants, and nurses on the management of chronic diseases, hypertension, diabetes, asthma, COPD, depression……
All this will require significant resources in education. In the coming days we will devote a significant article to the actual decision once the smoke clears, but in the mean time CMS, and the states have to get this train moving. Move quickly, before the next political stop in the road.
If we are developing CME to increase physician competence, physician performance and patient outcomes, then healthcare prices should naturally decrease and quality increase. We need to take a whole new look at healthcare; I have a physician (specialty in geriatrics) who just spoke yesterday on the importance of less care at end of life. It’s a counter-intuitive idea (in modern medicine), but one that has proven to work in his practice; reducing cost and improving patient (and family) satisfaction.
There is still no strict definition on what alternative medicine really is. But presently, it borders on the broadness of description covered by what we know of as conventional or orthodox medicine. However, to define alternative medicine as we believe it to be, it may be a knowledge that is considered as unaccepted, untested and unscientific.