Reinventing American Health Care, by Ezekiel J. Emanuel, M.D

ezejuek(Community Matters) Politico Playbook: “Reinventing American Health Care: How the Affordable Care Act Will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System,” by Ezekiel J. Emanuel, M.D ., chair of medical ethics and health policy at UPenn; White House special adviser on health reform from ’09 to ’11; son of a pediatrician; older brother to Rahm and Ari (published this week by PublicAffairs): “In the short term the ACA has been a political disaster for President Obama and the Democrats. … And it has left the Obama administration in a perpetually defensive stance, depleted of the political capital needed to achieve progress in other important policy areas such as immigration and the federal budget. …

“Regardless of the short-term political costs, in the longer sweep of history, beginning in 2020 or so, the ACA will increasingly be seen as a world historical achievement, even more important for the United States than Social Security and Medicare had been. And Barack Obama will be viewed more like Harry Truman – judged with increasing respect over time. …

“The talk of efficiency and value as well as cost control and accountability for quality … signals a sea change … [that over time] will free up governmental resources and allow the country to invest again in the many things that have been starved for funds: rebuilding roads, bridges, and other infrastructure and investing in early childhood education, scientific research and development.”

–“Six Megatrends in Health Care” : 1) End of insurance companies as we know them – Effective date: 2025: “Insurance companies will either become purveyors of management, analytics, and actuarial services or integrated delivery systems actually employing (or contracting with) hospitals, physicians, and other providers to render patient care” … 2) VIP care for the chronically and mentally ill – 2020: “Physicians and hospitals will focus on keeping patients with chronic illnesses healthy and out of the emergency room and hospital … routinely screening for depression and other mental health problems” 3) The emergency of digital medicine and closure of hospitals — 2020: “Over 1,000 acute-care hospitals will close” …

4) End of employer-sponsored health insurance – 2025: “Fewer than 20% of workers in the private sector will receive traditional employer-sponsored health insurance” … End of health care inflation – 2020: “Health care inflation will be GDP+0%” … 6) Transformation of medical education — 2025: “three-year medical schools and shorter residencies … half of medical school clinical training will be outside of hospitals.” Amazon: $15.17 hardcover; $10.99 Kindle

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