The folks over at the Center for American Progress believe, as we do, that health reform is about more than making sure people have insurance. It's about retooling our health care delivery system so that it provides high quality care, spends health dollars sensibly, addresses chronic disease, and promotes public health. (In the unlikely case that you need any reminder about the chronic disease and public health messages, check out the CDC report that the diabetes rate has nearly doubled in the U.S.)
There are lots of ideas about how to repair our health care system. We write about them a lot, and MedPac has pulled a lot of the ideas together in its own reform roadmap for the elderly. CAP pulled together some of its own health experts as well as some other think-tankers and policy types to try to further braid the strands of these reform ideas. The result is a new book, The Health Care Delivery System: A Blueprint for Reform. You can download it here, and or read the Overview and Recommendations. We haven't read the whole book yet (although in the past we've spoken with and blogged about quite a few of the contributors), but here are a few key points from the summary:
Infrastructure: Health care depends on a highly trained, balanced, and motivated workforce; current and accurate information; and technologies that enable health professionals to use information in the right place, in the right way, and at the right time. An efficient and high quality system would rest on the foundation of people, knowledge, and the means for their application.
Organization: The most effective way to address our cost and quality challenges is to confront the root cause—the chaos in everyday health care. Efforts should focus on accelerating the organization of health care providers into team-like configurations so that they can adopt systems that are likely to reduce errors of overuse, underuse, and misuse, and improve the overall coordination of care.
Payment reform: Provider payment structures play an important role in how well the health care delivery system meets the goals of delivering efficient and high-quality care. Policies must work to align the desires of practitioners and health organization managers to serve patients with the incentives that come from how they are paid.
Patient activation: Polices on the demand side of the equation must focus on how best to engage individuals in their own health and care. This is increasingly important in the face of a growing chronic disease epidemic.
As CAP itself notes, a lot of these issues are actually quite bipartisan. Obama and McCain may be tearing into each other's coverage and financing plans, but they have a lot of similar ideas about overhauling and modernizing the system itself. So we share the hope that next year can be the start of long-overdue progress.