It’s time to begin the heavy lifting of healthcare reform. The constant state of uncertainty that surrounded the Affordable Care Act (ACA) before the 2012 presidential election has given way to the need to make healthcare reform work equitably and efficiently in the United States.
As we’ve seen over the past 3 years, overhauling the U.S. healthcare system won’t be easy. Consumers, insurers, and employers, small-business owners in particular, are concerned that the ACA’s requirements will increase premiums and ration care. Our runaway healthcare expenses need to be corrected, but are we ready for the changes that are necessary to rein in costs and realize high-quality health outcomes? In the ongoing process of executing the ACA, let’s not overlook some of the low-hanging fruit we need to address in order to begin to bring equity to the system without jeopardizing our personal health:
- Failure to effectively and efficiently integrate scientific evidence into healthcare decision making, resulting in overuse, misuse, and even (in some instances) underuse of health technologies.
- Insufficient and, in many cases, poorly designed and executed comparative-effectiveness and cost-effectiveness research.
- Adoption of newly approved technologies before evidence supports them, which contributes to spiraling healthcare costs without commensurate improvement in patient outcomes.
- Questionable financial incentives that drive premature dissemination of new medical technologies even when their impact on patient outcomes is unproven.
- Consumers who are largely overwhelmed with navigating the healthcare system.
- Insufficient focus and allocation of resources to promote wellness and disease prevention and to support care coordination for patients with complex health needs.
Implementing the ACA is a start, but unless we aggressively integrate evidence into our decisions at all levels—payers, providers, and consumers—costs will continue to escalate. Using evidence to determine which medical technologies give us the most “bang” for our buck is one way to stem the tide of rising healthcare costs. Are we ready to tackle the problem?