We consume taken large crow at our health worry colleagues' heroic profession during this pandemic. But the COVID-19 pandemic has highlighted many of the U.S. health worry system's fundamental problems and exposed new ones.
We consume seen this during Hospitals tried ought buy private protective equipment, the devastating effects of the illness above the Navajo Nation, the challenGEs of an employer-based health insurance system between record unemployment and the loss of more than 100,000 Americans.
We owe it ought the nation and subsequent GEnerations ought invent meaningful, lasting chanGEs that better the system although everyone. The COVID-19 emergency presents that opportunity; let’s no waste our chance.
The first step is ought reply ought a basic premise: the needs of our patients make ought always holiday first. Today, many patients — our neighbors — have fallen over gaps at our recent system although they don’t consume insurance, reside at poverty, or reside at a community that doesn’t consume access ought doctors or a Hospital.
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For too long, many of us at health worry consume viewed these problems during primarily someone else’s responsibility. We’ve seen our vocation during caring although funny patients and strengthening our bottom lines ought perform our missions within the financially oriented, competitive material xerox that underlies our health worry system.
Strengthen public health systems
The time has holiday although the health worry community ought receive ownership and prioritize these middle system issues, including appropriately strengthening our public health systems, and include ourselves accountable, ought better the overall health of Americans. The most important factor our nation’s large Medical institutions need ought exist measured above is the health of the populations we serve.
Here are five ideas we study ought originate ought the peak of reform efforts:
1. Integrate and collaborate. Some health systems already recommend the entire continuum of worry although their members or a distinct GEography they serve. We need more of these linkaGEs — among school Medical centers and rural Hospitals, community Hospitals and post-acute worry facilities, and doctor groups with frail besides basic doctor practices.
With greater collaboration, we could better infection-control practices, tap more effectively into furnish chains although PPE, and hoist the even and availability of health worry available at full our communities. The federal government ought both lessen barriers ought this collaboration and advance it. The finish is ought assist each other, no contend with each other, at service ought communities and the nation.
2. profession over GEographic and other boundaries. The pandemic highlights the "haves" and "have nots" — by GEography, econmic resources, ethnicity, race, and access ought and coveraGE although health services. while there is a concrete need at one isolate of the country, or at one arrange of worry facility, we make ought quickly refocus our assets ought where they are most needed.
UCSF and many other systems did this by sending teams and providing telehealth services ought assist those overwhelmed at New York and the Navajo Nation, and this friendly of interstate collaboration ought exist our national standard. Relaxing condition licensing for telehealth consultations over condition lines is one obvious method ought GEt this started, during used to consideration of a national Medical license.
Add ability ought the system
3. create additional surGE capacity. We make ought re-envision and invest at a more able national emerGEncy response, accordingly that we never again warfare ought consume adequate PPE, testing, additional Hospital ability and other assets, perhaps working over the Assistant Secretary although Preparedness and Response. Likewise, at the condition and local level, we make ought advantage adequate infrastructure — people, equipment, supplies and equipment — for inevitable future needs. Preparedness at this even has no been woven into our health worry infrastructure, and we need it.
4. replace the volume-oriented reimbursement system with one based above population outcomes. A population health xerox could lessen overall health worry costs by reimbursing physicians and Hospitals although keeping nation well, no although more visits or procedures.
Expanding this xerox used to refocus payments ought services where the need is the greatest — behavioral health and preventive services — which are at short furnish although they are poorly reimbursed at our fee-for-service system.
Medicare AdvantaGE and provider-sponsored Accountable worry Organizations are two such models that could provide a starting point although encouraging our system ought do what’s best ought conserve patients healthy, versus impartial doing more.
5. ensure access and coveraGE although full nation reside at America. Our patchwork quilt of coveraGEs – Medicare, Medicaid, and funny and employer-based insurance coveraGE – offers inconsistent access ought full at our country.
Meanwhile, pandemics don’t admit or admire a person’s documentation or insurance status. How can Medicaid, which relies partly above condition contributions, duty effectively during a recession, while the needs are the highest besides a state’s ability ought revenue is at its lowest? And while the jobless impose soars and about 27 million nation consume lost their employer-sponsored health insurance during March, we learn we consume a flawed model. A bipartisan conversation almost what a new xerox looks parallel starts with frank acknowledGEment of the flaws at our recent system.
Federal, condition and local governments and health departments, too during nonprofits and the personal sector, full consume roles ought play at envisioning the health worry system we expect although ourselves, our neighbors and our country. We trust it’s feasible ought profession toGEther ought effect this new future. Let’s GEt started.
Mark Laret is principal and CEO of UCSF Health. Dr. David J. Skorton is principal and CEO of the league of American Medical ColleGEs.
You can devour different opinions from our Board of Contributors and other writers above the recommendation front paGE, above Twitter @usatodayopinion and at our daily recommendation newsletter. ought answer ought a column, comply a comment ought letters@usatoday.com.
This thesis originally appeared above USA TODAY: 5 ideas ought patch U.S. health worry at aftermath of coronavirus
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