Health care reform and rescuing primary care
By Tom Banning
TAFP Chief Executive Officer/Executive Vice President
There is an old adage that political leadership is the art of finding a parade and getting in front of it. And the corollary to that axiom is that whether it’s a parade or an angry mob, it’s best to stay in front of it.
The drumbeat for health care reform might be the sound of a marching band or it could be the din of a brute-force mob for whom might makes right and passion wins over reason. Either way, the need to transform our health care system—and in so doing reinvigorate primary care—is being heard, and more importantly, understood by policy makers, opinion leaders, the business community and the public at large.
There is general consensus on the problems with our fractured health care system. It is plagued by ever-rising costs, administrative inefficiencies, poor quality, lack of health information technology infrastructure and an eroding primary care workforce, to name a few. So, after more than a decade of failed public policy, our health care system has finally reached a tipping point. It’s finally bad enough that fundamental, systemic change is inevitable.
Speaking of equally relevant axioms, politics is a reactive sport. In other words, politicians don’t get after airplane safety until the jumbo jet plunges into a swamp. The updated version of this rule is that in an information-based economy, a well-documented negative glide path, corroborated by a few obvious symptoms, has a virtual reality impact.
As this applies to health care, while the system may not be in the swamp yet, there are enough well-documented problems—the rising number of uninsured, increasing costs and decreasing access to care—that even if politicians are not necessarily feeling the pain, a lot of their constituents emphatically are.
Legislative consensus is gelling right here, right now. Every report accumulating on politicians’ desks, in their minds and perhaps in their hearts declares the restoration of primary care as fundamental to health system reform. The more senior and vocal health care policy experts in Congress, the new Obama administration and even the American Medical Association have endorsed or rediscovered ideas that have been incubating for decades: the medical home, payment reform and transparency. For the time being, they are all talking the talk. Perhaps they’ll also walk that walk.
The more vital set of questions is not if, but when and in what form will health system reform take place? Or more precisely, how long can family medicine hold its breath until the high water recedes?
Your Academy can’t and won’t wait on what will seem like the glacial pace of change as the Congress warms to the daunting task of systemic, primary care-based reforms. Bad is bad enough to finally make good on reforms, but family physicians are neck deep in that swamp full of alligators right now.
Your Academy has an ambitious internal and external agenda that is already warmed up and ready for takeoff. We have retained a top-drawer practice management consultant, Bradley Reiner, who is ready to help streamline and maximize every operational aspect your practice. We have joined with Atlantic Health Partners to buy-down the costs of vaccines. We’re working with Trammell Crow Company to provide additional revenue opportunities through investments in real estate and ancillary services. We have spent the interim between state legislative sessions aligning with several strategic partners to pursue an aggressive legislative strategy to lay the foundation and build the infrastructure for a primary-care-based system for Texas, while simultaneously supporting your practices. And we are evaluating software systems and legal teams that could recover under payments and late-paid claims owed to your practices with little or no financial outlay.
And that’s just phase one. Stay tuned.