On Monday, March 6, 2017 the GOP released their proposed bill called, the “American Health Care Act” (AHCA).
Republicans and (almost all rational) Democrats agree that the Patient Protection and Affordable Care Act (ACA) or “ObamaCare” has areas in need of improvement. Even President Obama himself agreed that improvements need to be made.
“When one of these companies comes out with a new smartphone, and it has a few bugs. What do they do? They fix it. They upgrade it. … But you don’t go back to using a rotary phone. You don’t say, ‘Well, we’re repealing smartphones,'” Obama said at a presentation in Florida in October, 2016.
But unfortunately, politics has gotten in the way of facts and real solutions…on both sides.
Some Republicans are trying to throw the baby out with the bath water while some Democrats are fighting to keep the baby wallowing in the dirty water. The question that is not being asked is, politics aside, “What actually works?”
A few years back, The Institute for Healthcare Improvement (IHI) coined the phrase, “The Triple Aim”. This idea is a framework “that describes an approach to optimizing health system performance”. It involves three main legs:
- Improving the patient experience of care (including quality and satisfaction);
- Improving the health of populations; and
- Reducing the per capita cost of health care.
So, in short, The Triple Aim means lowering the cost of care while making us healthier and helping us have a better health care experience. I think it’s safe to say that, in theory, all sides of the aisle agree with these three aims. The “how-we-get-there” part is where things get messy.
But putting politics aside, both sides have to acknowledge that there are solutions that meet those three aims and solutions that don’t. There are some solutions that just reduce the cost of care. Others that just make our country healthier. And still others just address the care experience. Those are the solutions that promote lots of debate and competing agendas. Unfortunately, these ideas are the only ones being talked about. The solutions that meet all three of those aims are the ideas that are most effective, but talked about the least.
I created a table (Triple Aim Health Care Solutions) that mocks up some of the ideas that have been proposed as fixes for American healthcare. I sorted them by which parts of The Triple Aim they meet and tried to be as neutral as possible in my evaluation (Though I admit that I am probably subconsciously biased-but I tried my hardest to overcome it). If a solution easily met all three areas of The Triple Aim, they ranked higher than those that only met one or two aspects of the framework model.
So what do you think? Did I miss anything? Hope this sparks a discussion! The only thing I ask is that you provide factual, balance, and rational (and I might add, compassionate) ideas and thoughts. Thanks in advance for sharing.