Monday, January 29, 2007

The Commonwealth Fund -Rx for Controlling Health Care Costs

The Commonwealth Fund website is one of my favorite sources of sober and intelligent analyses of solutions to our current U.S. health care crisis.

Today I received an e-mail alert from this highly regarded and generous private foundation, founded in 1918 by a woman philanthropist Anna M. Harkness, with then the "broad charge to enhance the common good". The current mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

But my e-mail alert today disappointed me because the #7 point health care expenditure reduction strategy that The Commonwealth Fund published cluster around the following themes and failed to highlight prevention My heart was broken and spirit dashed.

President Karen Davis and her Commonwealth Fund colleagues believe that change can come about by:

-Reshaping market incentives to reward value-driven health care and increase competition

-Generating information on the clinical effectiveness and cost benefit of medical services to support coverage policy and medical decision-making

-Reducing high insurance administrative overhead and promoting competitive pharmaceutical prices

-Reforming provider payment systems to reward efficient and effective care

-Strengthening primary care

-Investing in health information technology

-Investing in insurance reforms to ensure access, affordability, and equity.

Yet this all seems quite admirable!?

If one delves into the report there is reference to prevention as one of "the most desirable strategies" from a public perspective. But prevention seems to get lost in what I can only presume is "Commonwealth" believing that prevention is not yet a politically viable option in the current 2 trillion dollar U.S. "disease care" system-err industry?.

I and others posit that our disease care system is economically unsustainable and that prevention is,in the end,our only real way out of this economic wilderness.

I frankly do not understand why there remains so much resistance to prevention? I personally believe Americans are ready and able to accept it.

But as I have said on this blog a $2 trillion dollar industry doesn't just roll over for those among us who believe so much in prevention and public health. Too many dollars on board for this giant ship to make a sharp turn in choppy waters?

I'd like to hear from you

Be Well,

Dr. Rick Lippin


Blogger Cervantes said...

It is true that the CwF does focus on health care and the health care system, rather than having a broader focus on public health. As I have often said, this is a seductive tendency for all of us, because health care is easier to encompass and to influence. It's a coherent system, it's 16% of the economy, it has powerful hierarchies and organized institutions, whereas public health is more diffuse, more diverse, harder to get a handle on.

But I agree with you, I wish they would adopt a much broader agenda. Maybe they'll listen to us. (They have given me a small amount of money for more broadly construed public health work, so it's not all bad. But the emphasis is definitely on medicine, not health.)

7:37 AM  
Blogger xine said...

"Reshaping market incentives to reward value-driven health care and increase competition"

The Commonwealth Fund on the value based bandwagon? Say it ain't so!

1:28 PM  
Blogger Blake said...

Thank you both Cervantes and xine. I learn alot from The Commonwealth Fund but I fear they are not stepping up NOW that we have a chance (since Nov 6) of actually DOING -not just writing-something about our wrecked health care system.

I read their mission statement words carefully and they need to live up to that statement.

Dr.Rick Lippin

1:47 PM  
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