"Now what?" As hope for federal reform fades, that's the question on the lips of healthcare executives and policymakers.
Many of the structural problems of America's healthcare system have yet to be addressed. Costs still are rising more rapidly than overall inflation. The problem of the uninsured still looms. And the medical-care delivery system focuses too much on specialists and not enough on prevention.
Executives deserve credit for taking preliminary steps to find the answers to healthcare's problems, but much more needs to be done. Here are some challenges for the months ahead:
Healthcare providers must step up efforts to wring costs out of the system by increasing operational and clinical efficiency, reducing inappropriate tests and procedures, and consolidating costly high-tech services regionally. Forming networks to gain market share rather than serve community needs only perpetuates the outmoded, capital-intensive, costly and overbedded healthcare enterprise.
States must stop looking to Washington for action on guaranteed health insurance for all Americans and develop solutions to cover more uninsured. Florida isn't waiting; it's been given a waiver to subsidize insurance for those who are now uninsured and ineligible for Medicaid. More states must step up to the challenge.
The insurance industry must act immediately to simplify and standardize claims forms, and to pursue efforts to establish insurance portability and expand community rating.
Businesses must not use self-insurance programs or engage in fear-mongering to avoid their responsibilities to their employees. Too many hide behind unproven job-loss data in opposing expansion of employer-paid insurance.
The public must assume responsibility for unhealthy lifestyle choices and demand more of a role in medical decisionmaking.
The fight for reform is far from over. With attempts by Congress to cut Medicare and Medicaid funding to achieve deficit reduction a certainty, healthcare cries out for leaders to spearhead real, substantive change.