Achieving Health Care Reform — How Physicians Can Help (New Eng Jour Med)

[pinto]

(I'm unfamiliar with this cited publication - 'Crossing the Quality Chasm, the Institute of Medicine (IOM)' - posting for review. ~ pinto)

Achieving Health Care Reform — How Physicians Can Help
Elliott S. Fisher, M.D., M.P.H., Donald M. Berwick, M.D., M.P.P., and Karen Davis, Ph.D.

http://content.nejm.org/cgi/content/full/NEJMp0903923?query=TOC

This year, we have the best chance in a generation of enacting legislation worthy of being called health care reform and of setting the United States on the path to high-quality, affordable health care for all Americans. The recent commitment by several major stakeholders — including the American Medical Association — to slowing the growth of health care spending is a promising development. But the controversy about whether the organizations actually agreed to a 1.5-percentage-point reduction in annual spending growth is just one indication that success is still far from assured.

Two threats in particular put reform at risk: conflicting doctrines (regarding the creation of a new public insurance option and government support for comparative-effectiveness studies) and opposition to change among some current stakeholders. In the face of this uncertainty, physicians have a choice: to wait and see what happens or to lead the change our country needs. We'd prefer the latter.

Physicians should first help to create a shared vision that could overcome doctrinal divides — and bring providers together to create a system better aligned both with public needs and with providers' fundamental interests and values. The starting point is to recognize, as most physicians do, that improving a complex health care system requires action on multiple fronts. In its landmark report Crossing the Quality Chasm, the Institute of Medicine (IOM) described a "chain of effect" that links systems at four different levels as the interrelated determinants of health care quality that must be aligned for reform to yield the desired results.

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Ultimately, we believe that the United States can reduce its per capita health care costs — without harming patients — by much more than the proposed 1.5-percentage-point reductions in growth would shrink them. But let's make that deal stick. Physicians can become our most credible and effective leaders of progress toward a new world of coordinated, sensible, outcome-oriented care in which they and their communities will be far better off. Defending the status quo is a bankrupt plan, and physicians have an opportunity to help us all see beyond it.

Dr. Fisher reports receiving grant support from Aetna and consulting, teaching, or speaking fees from Regence Blue Shield, RAND, Kaiser Permanente, the Center for Corporate Innovation, Blue Cross Blue Shield of Montana, and numerous provider organizations and medical associations. No other potential conflict of interest relevant to this article was reported.

Source Information

Dr. Fisher is a professor of medicine and of community and family medicine and associate director for Population Health and Policy at the Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH. Dr. Berwick is a professor in the Department of Health Policy and Management, Harvard School of Public Health, Boston, and president and chief executive officer of the Institute for Healthcare Improvement, Cambridge, MA. Dr. Davis is the president of the Commonwealth Fund, New York.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.

http://content.nejm.org/cgi/content/full/NEJMp0903923?query=TOC

[avaistheone1]

1. This doctor is pretty much bought and paid for by the health insurance industry.

I don't trust her at all. She is just another corporate shill - just a shill from Harvard.