Decisions Made in 2010 Set Course of Medicine by Dr. David Lipschitz on Creators.com

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Decisions Made in 2010 Set Course of Medicine

In this new year, let us resolve to be more peaceful, healthy and hopeful for the future. As 2009 ended with a severe and bitter battle over health care reform, I can only hope the new year will bring renewed enthusiasm and hope for health and health care. The journey for true reform is in its infancy, and there is much that needs improvement. Decisions made in 2010 can help make America the healthiest nation in the world.

Sadly, I do not have the will or the time to read the 1,000-plus pages of the most recent iteration of the proposed health care bill. But based on many summaries and analyses of specific elements of the legislation, I believe there are many positive things in the House and Senate bills.

Perhaps the greatest promise is that many more Americans will have access to health care. As the richest nation in the world, America should provide all its citizens with quality and accessible care. With the proposed reform, this is possible.

Beyond the overarching goal of increased coverage, I am encouraged by the elements of the bills that target the delivery of health care. There are proposals to change the reimbursement models for physicians, to encourage early detection of disease and to provide greater resources for disease prevention.

Currently, physicians are reimbursed for services delivered. Performing more tests and procedures leads to more money and a higher salary. Although it is unclear how the government will achieve their goals, the House and Senate version of health reform link payment to quality rather than quantity of care.

Americans enrolled in Medicare and Medicaid may benefit the most from these renewed emphases on quality care. The reform bill plans to create a new Center for Medicare and Medicaid Innovation, which will be charged with studying better approaches to health care delivery and practice. Living in a rural state, I am particularly encouraged by the assurance that every effort will be made to improve care in rural America.

Without question, there appears to be a greater commitment to prevention, including the creation of more school-based health clinics and oral health care education programs.

There is also a promise to support community-wide prevention strategies and increased innovation in public health, including work-based wellness programs and educational efforts to attack poor health habits, such as smoking, poor nutrition and a sedentary lifestyle.

There is also a proposal to offer Medicare coverage, with no co-payments or deductibles, for annual wellness examinations and the development of individualized prevention programs. Currently, Medicare patients are given a one-time opportunity for an annual physical upon entering the program at age 65. After that, patients must have clear medical reasons to see their physician and receive Medicare coverage. Providing coverage for an annual physical and prevention counseling will be an enormous benefit for older adults.

In general, legislators seem to have recognized that, whenever possible, medical treatment decisions should be based on sound scientific evidence of benefit. More research will be done to compare different approaches to care, and this information will be made available to patients and physicians.

The bill also addresses manpower issues in medicine by providing increased support for primary care physicians, physician assistants, nursing and dentistry. There is a renewed commitment to education in rural areas, to geriatric training for all health care providers, and to a public health service track to train physicians, nurses, dentists and behavioral therapists in public health, epidemiology and emergency preparedness.

As a physician, I believe that creating greater transparency and program integrity will do much to improve health care and restore trust in American medicine. Proposed legislation will prohibit the development of new physician-owned hospitals, and any gifts given to physicians, their practices, medical schools and hospitals must be publicly reported.

Despite all the rancor and negative press, there are some good things in this bill. I have chosen to highlight components of the bill that I find truly encouraging, but I am sure there are many who continue to see flaws. But this is a start. As always, the devil is in the details. What happens in 2010 will set American medicine on a new course. I desperately hope it's a good one. Our future depends on it.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.