Alex Azar, the Health Secretary in the Trump administration, has outlined ambitious plans to achieve “value-based transformation” when it comes to American healthcare. He is responsible for overseeing everything, inclusive of Medicare and Centers for Disease Control and Prevention. He said that the present US healthcare system does not deliver results as per its costs. He bemoaned the fact that the US healthcare is paying for the sickness and procedures- and not the outcomes and wellness. He said that some kind of consumer market is the need of the hour in the healthcare sector.
Azar's assertion goes directly against the two factors which go against it. One factor is the system which can be described as “fee for service” and the absence of transparency for both products and services. The former means healthcare providers including hospitals make greater amounts of money via offering more services. This is independent of the clinical value of these extra services.
The price transparency problem does not lie with the hospital services. It has to do with health insurance prices. The consumers, if aware of how much they are paying for their health insurance, and if they enjoy some real options to shop around, could enjoy the power to push for significant changes in the US healthcare.
Changing times, changing acts
For Azar to do what he wants, the first thing he should do is to unravel the many years of mistakes done by Washington. The first activity is to permit patients to access and also share their personal data. The patients must enjoy control of personal records in a format which is useful to them. They should have the power to import their records if they migrate to a new provider. These are presently prohibited by old laws like Health Information Technology for Economic and Clinical Health Act (HITECH) 2009 and Health Insurance Portability and Accountability Sct (HIPAA) 1996. These acts were made prior to the invention of the Internet and the smartphone. The rationalization of such regulations makes it much easier for the patients to utilize their medical records.
The hospital costs must also be reduced. The Congress has recently passed a few acts which have resulted in increasing hospital monopolies. Hospital systems are encouraged by the ACA to purchase private practices in a manner which will expand the market power of hospitals. This may lead to steeper prices. It is good that Azar has the power to revise ACO rules.