Healthcare Reform – It’s not my fault
When President Obama launched his
attempt to reform healthcare Diabetic Investor speculated whatever plan he came
up with would make everyone unhappy. The fact is healthcare is a multi-billion business
and no one wants their particular area or interest to suffer. This is the same
reason Diabetic Investor long maintained that healthcare reform really has
nothing to do with the quality of patient care or emphasizing preventive care,
the healthcare reform movement is all about getting patients covered and
controlling costs.
With so much money at stake it’s
hardly surprising that we have seen strong emotions from all sides. Opponents of
reform have used every tactic in the book to frame healthcare reform as another
government intrusion in our lives. Advocates of reform point to the rising cost
of care and that if nothing is done costs will continue to spiral out of
control.
What’s laughable about this
current debate is that it’s really nothing new. Healthcare reform has been
talked about since the Johnson administration and each attempt at reform has
been meet with similar arguments. About the only theme that remains constant is
that our system is broken and needs to be fixed. Yet no one can agree on how to
fix it or put another way no one is willing to acknowledge that real reform everyone
and we mean everyone must give up something they currently have.
Diabetic Investor has stated on
several occasions that you cannot have healthcare reform without tort reform.
Far too many physicians are forced to practice defensive medicine ordering a
multitude of tests to protect themselves just in case something goes wrong and
the patient sues. Lawyers argue that tort reform will do little to help as
defensive medicine adds only a fraction to the cost of healthcare. They argue
with some truth that many physicians order these test not because they are
practicing defensive medicine rather as method to increase their incomes. Physicians
respond by stating that it is the patient who wants these tests to insure they
are getting the best possible care. And around and around we go.
Patients themselves are not
immune to the debate. There are many on both sides of the aisle who believe
that patients contribute to the rising cost of care by not taking care of
themselves. As with so many arguments there is an element of truth here as
millions of Americans are obese, smoke cigarettes and fail to exercise. It is
also true that millions of patients fail to follow even the simplest steps to
take care of themselves. We see this everyday in the diabetes community as it
is a well known fact that therapy non-compliance contributes to the fact that
nearly two-thirds of all patients are not achieving control.
Making matters even worse is the belief by
many officials that we can somehow live in world where physicians never make a
mistake or that every drug should have no adverse events ever. The fact is
physicians are human and humans make mistakes. It also true even with all the
sophisticated tools physicians have at their disposal medicine is not an exact
science. Add in the fact that patients don’t always follow what they are told
to do and you have one big mess on your hands.
Having covered the FDA for
sometime Diabetic Investor has seen firsthand how just out whack the system is.
We cannot pinpoint when the FDA lost perspective on risk/reward but today’s FDA
appears to be hell bent not to approve any new drug if it shows even the
smallest possibility of causing an adverse event. Here too the diabetes market
is a perfect example. No matter how one feels about Avandia the controversy
over the drug has forever changed how diabetes drugs will be approved by the
FDA. Or take a look at the recent PQQ enzyme issue with blood glucose monitors,
an issue that will important effects less than 1% of the entire diabetes
patient population. Still the FDA in their standard fashion uses a nuclear
weapon to kill the common house fly.
This is why when it’s all said and
done healthcare reform comes down to two factors, getting everyone covered and
controlling costs. Healthcare reform has nothing to do with providing better
care or preventive medicine. For all the talk about electronic medical records,
malpractice insurance rates and frivolous lawsuits these are just smoke screens
covering the real issues. Getting everyone covered while a good step could actually
contribute to the problem. Having access to care is one thing, having access to
quality care is a completely different issue.
That being said cost control is
coming and in some ways has already begun. Once again the diabetes market is a
prime example of where healthcare reform is headed. As Diabetic Investor has
been stating the day is coming when insurers in an attempt to control costs and
increase profits will no longer reimburse non-insulin using patients for their
testing supplies. Already we have seen insurers push more of these costs to the
patients by raising co-payments. Never mind that if patients were properly educated
on the value of testing costs would actually decrease, that would only be logical
and logic is something not seen in this debate.
This debate of healthcare reform
reminds Diabetic Investor of the blood glucose monitoring market, a market that
has undergone tremendous change over the past few years. Once fat and happy
companies ignored the changing market dynamics and now are wondering what went
wrong. As they sit around the table they look for someone to blame with each
person saying it’s not my fault. Truth is everyone played a role and the same
will be true with healthcare reform. When a bill is finally signed and everyone
starts complaining politicians, the many companies involved in healthcare and
voters will sit around looking for someone to blame when in fact everyone will
have played a role. And as sure as night follows day, this debate will start again
as once again we’ll attempt to fix a broken system of our own making.
