With sweeping healthcare reform proposals seemingly now on their way to the legislative dustbin, policymakers more than ever need to avoid the temptation to throw roadblocks in the path of industry transformation.
It may be too early to say that major reform is dead. But clearly a stake has been driven through the heart of the most grandiose proposals.
Meanwhile, organized medicine is making headway on efforts to protect the status quo through any-willing-provider legislation. Such laws obligate managed-care plans to enroll any physician willing to accept the plan's reimbursement and live by its quality and credentialing criteria.
The laws are painted as benign efforts to ensure that patients can choose their own physicians. But the truth is that such requirements tie the hands of those seeking to find better ways to provide cost-efficient, high-quality managed care.
The House Ways and Means Committee was misguided when, at the 11th hour, it included an any-willing-provider requirement in its reform plan. Members watered it down with exceptions to make it more palatable, but it still reflects wrong-headed, protectionist thinking about how the healthcare delivery system should operate.
If the healthcare industry is going to transform itself into an enterprise that is responsive to consumer choice and cost and quality concerns, health plans need the flexibility to exclude individuals and facilities that don't measure up to their standards or reflect their values. Lawmakers should avoid protectionism and focus on providing a marketplace that facilitates good faith negotiations among providers, payers and consumers.