MMA Viewpoint
Health Care Reform in a Down Economy
Minnesota physicians should be rightly proud of the role they played in the development of the state’s 2008 health care reform legislation, which seeks to improve the health of society while reducing the cost of care. The Minnesota Medical Association has been on the frontlines of reform, working through its Health Care Reform Task Force and convening the communitywide Healthy Minnesota: A Partnership for Reform initiative, the recommendations of which were used to help craft this historic legislation. We know that health care reform has been—and will continue to be—a gradual process. Circumstances such as the economic downturn will likely slow our progress. But there are things we physicians can do as individuals and as part of larger health systems to continue moving ahead with our efforts during these challenging times.
Minnesota’s health care reform efforts follow the Institute for Healthcare Improvement’s “triple aim”: to enhance the patient experience, to improve the health of the population, and to reduce or control the per capita cost. By working in their practices to find new and better ways to apply the Institute of Medicine’s characteristics of quality—health care that is safe, timely, effective, efficient, equitable, and patient-centered—Minnesota physicians can find ways to improve their patients’ experiences. Working within their organizations, they can also find ways to reduce ineffective care and thus cut costs. It is estimated that as much as 30 percent of U.S. health care spending is unnecessary and wasteful. That translates to $600 to $700 billion being spent annually on services that do not improve health.
Although Minnesota is doing much better than the national average, physicians can do more. The National Quality Forum’s National Priorities Partnership recommends that we aim to reduce or eliminate inappropriate medication use and nonpalliative services at the end of life; unnecessary laboratory tests and consultations; unwarranted maternity care interventions and diagnostic and other procedures; preventable emergency department visits and hospitalizations; and preventive services that are potentially harmful or have no benefit. This is a win-win endeavor. By reducing some services, patients will receive safer, better care; total health care costs will be reduced; and the savings can be used to provide services to those who are presently uninsured.
Compared with physicians in other states, Minnesota physicians deliver health care that ranks in the top quintile for quality and the bottom quintile for cost. If health care delivery across the nation were at Minnesota’s level for quality and cost, we could see an estimated savings of more than $1 trillion over the next 10 years. Clearly, Minnesota physicians have already shown their willingness to take the lead nationally on quality improvement, cost containment, and reform. Yet there is much more to do.
The Minnesota Medical Association is committed to working with government leaders on health care reform throughout these difficult times. We will continue to advocate for Minnesota’s citizens and physicians. And we will continue to provide strong leadership as we reform our payment system, insurance market, health care delivery system, and public health system. Working as individuals and through the MMA, we physicians will continue to lead the way.