Friday, September 25, 2015

The Perils of Government Involvement in Health Care

A Disease Management Care Blog spawn is implacably opposed to a Romney Presidency.  The argument is that while there's admiration for Mitt's successes as a businessman, running a government is better left to accountable politicians.

Which the DMCB appreciates. That doesn't mean there isn't a downside to the meddling of Republicans as well as Democrats.  Take health care for example.

Turbocharged by decades of direct government funding and favorable tax policies, insatiable healthcare consumer demand has created a medical-industrial bubble that is eating close to 20% of the U.S. economy.  Since Washington DC's direct costs are outstripping tax receipts, the same political process that got us into trouble is now supposed to get us out.  While the President's proposed 2015 budget has some painful cuts, that's nothing compared to the looming havoc being threatened by the coming fiscal cliff.  This is government accountability?

For a smaller example of the dysfunction created by government meddling, consider the electronic health record (EHR) mess.  Despite warnings from the DMCB that EHRs' documentation capabilities enable increased billings for the same care, both Presidents Bush and Obama promoted the EHR as an informatics cost-reducing panacea. 

It turns out the DMCB was right. This OIG report raised the possibility that EHRs are behind a recent coding uptick, which was further examined in this telling New York Times article by Reed Abelson et al

Government response? This threatening warning to stop using a product as designed that our political class had promoted all along.

(Latest update: Reversing course on years of being conspicuously silent in the face of the Adminstration's health reform bullying, the hospitals are pushing back.   Nothing like the threat of budget cuts to clarify just who your allies are - and aren't.  The cliff promises to be an interesting ride.)

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