It wasn’t that many years ago that few people had healthcare insurance and they only went to the doctor when faced with life-threatening injuries and illnesses. For virtually everything else, they utilized a variety of home remedies and over-the-counter treatments.
Over the years, that changed. The Affordable Health Care Act, known as Obamacare, is on track to curb over-utilization as a means of reducing healthcare costs.
Comfort Over Care
When designing the Act, the views of Dr. Ezekiel Emanuel weighed heavily in developing Obamacare.
A key advisor to the president, he advocated reducing costs through a combination of methods that includes scaling back on “luxury” services, tests and technology.
The Act assumes that patients are self-indulgent and demand amenities that aren’t necessary for their treatment or recovery.
Those demands include expensive hospital rooms, attractively appointed waiting rooms, convenient parking and facilities designed for comfort rather than utility.
Practitioner Protection, Medication And Patient Ignorance
Obamacare works on the theory that clinicians prescribe tests, utilize high-dollar technology and schedule office visits that aren’t needed as a way to earn more money and protect themselves against potential litigation.
Obamacare further cites drug prices that are 10 to 30 percent higher in the U.S. than other countries, marketing costs, and the fee-for-service payment model for rising prices.
Malpractice insurance and consumers’ ignorance of the true cost of their healthcare were also named as factors for skyrocketing prices.
Back To Basics
Obamacare offers a multi-pronged attack that focuses on the cost element of the healthcare equation. Medical professionals and facilities that produce desired patient outcomes are rewarded financially.
The goal is for practitioners to use fewer “unnecessary” tests and technology to determine exact causes and rely more on exams and a patient’s health history to prescribe medications, devise treatments and expedite recoveries.
The cost for using the technology remains the same, but it’s utilized less as a means of lowering costs.
Patient Responsibility
Individuals are tasked with paying more of their healthcare costs and utilizing preventative measures to keep themselves healthy, as defined by their healthcare policy.
Employers and insurers are using financial incentives to promote healthy lifestyles, and encourage people to stop activities or practices that are deemed detrimental, from not getting enough exercise and giving up tobacco to eliminating soft drinks.
Taxes are imposed on people with “Cadillac” policies that Obamacare says encourages over-utilization of services, an outlook that could be an incentive for limited benefit packages in the future.
Those without insurance are penalized for their irresponsibility in not carrying coverage.
Physician Strategies And Struggles
Under Obamacare, practitioners are urged to return patients to a functioning condition as quickly as possible by less expensive means than currently employed. The Act reduces Medicare reimbursements and bundles payments for in-patient hospital stays and post-discharge treatments that were previously billed individually.
Obamacare advocates e-care monitoring at home to avoid hospital admissions, readmissions, and stays in skilled nursing and long-term healthcare facilities.
Independent Payment Advisor Board (IPAB)
Obamacare operates under the theory that access to technology automatically equates with overuse.
IPAB has been charged with finding ways to cut Medicare costs and making recommendations for treatments that automatically go into effect unless Congress moves to block them.
The organization is responsible for determining which treatments and procedures, in the collective opinion of its members, provide the best results/value for the money spent.
The rising costs associated with healthcare are due to a variety of factors associated with a capitalistic society. Obamacare attempts to address those issues with multiple methods that changes the way healthcare is purchased and delivered, combined with an array of taxes on policies and penalties for non-compliance.
