At least it is a start in recognizing the problems and attempting to address them from the healthcare provider side of this multivariable equation. Insurers of healthcare, for example, should be more than just the financiers of healthcare services. They should also assist ACO providers in the new roles that they are expected to assume.
And how about the patient? Does he or she have any responsibility other than paying taxes and insurance premiums, and maybe showing up to be taken care of and be educated by an ACO physician? To what extent should the patient be expected to understand what ACOs are all about before deciding whether to cooperate?
One could logically argue that the most important variable in the American healthcare system equation is an educated and informed citizen, a process that ideally begins long before their entry into the healthcare system, or entry by someone for whom they are responsible or concerned. We know that reading, writing, arithmetic and thinking are the bulwarks of education in the U.S. Why not add knowledge of personal health and the American healthcare system? What could be any more important in life than understanding how to care for self and others throughout life?
Such literacy, if begun and required from grade one through college, would be most useful to politicians, regulators, clinicians, insurers and citizens themselves as patients and caregivers to those they love—a child, spouse or parent. Although this is a long-term variable that involves cultural change and will span many political careers, there is an urgency that it begin today.
Educators will argue that students already get physical hygiene education and learn about unhealthy habits and lifestyles. But what do they know about illness, disease, chronicity, healthcare professionals, providers, economics, insurance, the elderly, the right questions, who to ask, where to start and so on, until they are actually confronted with a problem and are required to learn as they go.
Educators will argue that these topics will place an additional unwelcomed financial burden on education in preparation and teaching. Perhaps they are topics that could be creatively integrated into the readings, problem solving and exercises of existing curriculums.
So, is the ACO the answer? Not entirely. It is, perhaps, a new approach in helping to better define the problem nationally and in helping to identify other long-term solutions. Past approaches, whether for healthcare research, the provision of healthcare services or healthcare basic individual education, are scattered at best. Organized and cumulative knowledge and literacy about healthcare seems to be a way of bringing it all together for better understanding and a better, more rational healthcare future.
George Huber is associate dean for public policy at the University of Pittsburgh Graduate School of Public Health.