Shortly after Representative Paul Ryan's name was stamped on the Republican's presidential ticket in early August, the nation's electorate invited a divisive discussion hinged on the future of entitlements, namely: Medicare and, to a lesser degree, Medicaid.
After the Supreme Court handed down its decision (National Federation of Independent Business vs. Sebelius, Florida vs. Department of Health and Human Services) in late June, the national health care conversation quickly changed course. Americans were no longer concerned with a question of legality; instead Americans were concerned with a question of practicality -- is this right for me?
With the election less than two months away, America's health care conversation has been used to stoke political flames, which attempt to "divide & conquer" and marginalize facets of the American electorate. This conversation should instead work to invite public and private bodies, physicians, and, above all, patients to an honest, up-front dialogue centered on the future of health care.
The American health care system, like any other market-based clearinghouse, is bound to the categorical nature of economics. Consequently, for the market to maintain stability for patients and physicians alike, a shift in health care demanded must be met with an equal, directional shift in health care supplied. Yet despite this objectivity, misleading political rhetoric has still persistently inundated the health care debate. President Obama, and the House Democrats, have pushed measures -- most prominently, the Affordable Care Act -- to expand Medicaid Access, and in doing so, Democrats dissolved $716 Billion from the Medicare Trust Fund. Whether the $716 billion was "gutted" (as Republicans quip) or "saved" (as Democrats retort) still remains the crux of this ever-heated health care conversation. And although I applaud the president on ambitiously expanding Medicaid access, any additions to our existing system without an almost equal rise in supply (more doctors, hospitals, etc.) would simply prolong already lengthy waiting periods and, ironically, make care less accessible.
It is projected that by 2020, the American health care system will be short 40,000 primary-care physicians, and, in the years soon after, this void is only expected to widen. America's health care system, resembling an unhurried sedan on a one-way street, faces poor infrastructure and congested traffic conditions. In 2012, it's clear that now is the time to change course.
In reforming America's health care system, we must not only invite ideas from the public sector, e.g. Health and Human Services, but the private sector as well. Under a number of auspices, the private sector has catapulted its way into the "public" sphere of health. Take the recent emergence of Convenient Care Clinics. These clinics, which are mainly staffed by nurse practitioners (NPs) and physicians-assistants (PAs), surprisingly are housed not in hospitals or medical centers, but instead in a bustling retail ecosystem. Yet despite their location, these retail clinics still provide for what Americans seek in the world of health care: treatment for uncomplicated illnesses and preventative solutions (e.g. seasonal vaccines). Retail clinics, standing at a critical nexus, bring together the strengths of both preventative care and receptive solutions in an effort to increase the supplied health care domestically.
In mid-August, Kathleen Sebelius, Secretary of Health and Human Services, visited a CVS retail clinic -- branded the "MinuteClinic" -- in Jacksonville, Florida. Per a report released by Health and Human Services, Secretary Sebelius's visit was intended to highlight "new benefits and options for Medicare beneficiaries that will help them stay healthier." Some of these include: "A free annual wellness visit... as well as a wide variety of preventive tests and screenings, most at no cost to patients." CVS's (private sector) workings with HHS (public sector) can expand access in areas where physicians are few and hospitals are short-staffed, all while abating the ever-evolving financial burdens elicited by health care's input costs.
Visiting retail clinics before pandering in crowded emergency rooms also helps the greater market for all Americans seeking care. Retail clinics give patients, who may not necessarily need "emergency care," a sensible option before deferring to their primary-care physicians. Not only do these clinics expand Medicare access and lift the burden on the traditional system, they also provide a more approachable route for the uninsured. The first step in fixing the American health care system should not be whom we let in, but instead where we let them in. It's clear that retail clinics lay the groundwork for a new path to health care, a path that's both sustainable for taxpayers and patients, which, more than not, are one in the same. Unsurprisingly, a 2008 Survey of Health Care Consumers explains that one in three Americans are the receptive to the idea of using a retail clinic, while one in six already has.
Expanding basic access should not only hinge on brick-and-mortar establishments -- it, too, should spark lattical networks that better connect patients and physicians online. In May 2008, Google announced "Google Health," a project directed toward "personal health information centralization." Witnessing initial privacy complaints and a shrinking user-base, Google ended up discontinuing the project in January 2012. It's clear that this deficit of "broad appeal" underscores the ever-growing importance that the public sector must help buttress next-generation health care projects. By widening appeal, both sectors will find a clear, straight path will let gives Americans access records, related-symptoms, appointments, and prescription refill services. Seamless connections are vital to system that works for patients and physicians alike.
So, Republicans and Democrats, Senators and Representatives, local commissioners and state legislators, answers to our nation's health care debate won't be found in the narrow, ideological division of small government vs. big government; instead, answers will be found in the unity, compact, and cooperation which makes for smarter government. A smarter government that doesn't stand between a patient and her doctor, but one that brings the two together fiscally and responsibly.
Although the avenues that lead to the often-elusive destination of affordable care are slowed down by our ever-growing system, it's clear, more than ever, that Americans seeking genuine, affordable solutions ought to have a clear path to access. A path where waiting periods and physician-shortages don't exist to aggravate the acute to the chronic and the symptoms to the struggles. But, above all, this path must be embedded with the principle, not the political.