The newest class of federal, state and local elected officials has now been in office for a couple of months. These representatives tipped the balance of power from a democratic to republican majority in the U.S. House of Representatives.
The GOP also picked up seats in the U.S. Senate. This shift in power is just the latest in the long history of American politics, because the reality is that Washington, D.C., is in a constant state of change.
As with any shift, however, we can expect priorities to change, with some issues receiving less attention. Such priority issues as the economy, jobs, education, national infrastructure and defense will remain at the top of the national agenda. Health care will also remain at the forefront of the discussion, regardless of who’s in power or who’s for or against health-care “reform.”
Health-care reform is unique for EMS professionals because it affects us as individuals, our families, our careers and the organizations we work for, which makes it critical that we help government get it right.
It has become clear over time and in this past election that reform can mean a lot of different things to different people. Given the magnitude of the ongoing and climbing investment in health-care delivery, education, technology and pharmaceuticals, it will be increasingly more difficult to avoid health-care policy discussions.
When I’m asked whether the power shift in the U.S. House of Representatives is going to stall health-care reform, I respond, “The train has already left the station.” It’s unlikely that health-care reform will be sidelined in national, state and local legislative and public policy arenas because no one can stop the speeding train that is the U.S. health-care system.
With this said, there’s a good chance health care may remain a political hot potato, and the pace of the reform could be slowed.
President Obama likely won’t retreat from his health-care agenda, but the republican-controlled House can choose not to fund, or to underfund, health-care initiatives.
Health care may also be seen as a political hot potato because it’s a complex issue, which affects everybody and is as personal as your next visit to your doctor or emergency department.
If the system is working for you and all you have is a small co-payment for your visit, then you may not see the need for change. But if the cost is suddenly more than you can afford or you have a bad outcome that affects your ability to work or care for yourself or your family, then the system is no longer working for you; you may experience the necessity for change firsthand.
Pragmatically, none of us can afford to continue to ignore the screaming need to get a handle on health-care costs, access and quality. So although modifications will be made to the health-care reform legislation, it’s clear that if we’re ever going to get our arms around costs, now is the time.
Those of us in health care know the wisest way to address illness is prevention. The second most efficient way to control health-care costs is expeditious treatment when clinically appropriate. Therefore, investment in methods to help keep the U.S. population well by covering preventive treatment and putting greater emphasis on primary care—as outlined in the health-care reform legislation—must continue, but it will take many years to accomplish.
Getting it Right
Health care is one of the few things that affects us from cradle to grave. Unless you have enough cash on hand to never worry about how you will pay for health care, you need to encourage the public and private sectors to work together to get it right.
The bottom line is that health-care reform has to be about common sense. We must encourage republican and democratic legislators to work together to pursue the best way for patients to access systems at a reasonable cost, using the best technology and demonstrated best practices.
We can’t afford to implement changes just because we think something works. We must insist on processes and procedures that stem from evidence-based best practices designed to achieve the best possible patient outcomes.
A lot can go wrong in health care for the patient and the provider, and every decision makes a difference in the care of patients and safety of providers. All of us can reflect on an injury we’ve managed that most likely could have been avoided through closer attention to detail. Think of reflective striping on a uniform as an exmaples of a small detail that can prevent serious injuries for first responders.
Attention to detail is critical throughout health care, and it’s a must during health-care policy development.
EMS providers need to be able to explain how every decision and change affects EMS. You must make a special effort to communicate with and educate legislators, both freshman and incumbent, about the complexities of the health-care system from EMS to rehab.
And we should highlight things that are truly important. This will help ensure their policy decisions can help us provide better care and prevent providers from being run over in the process. JEMS
This article originally appeared in February 2011 JEMS as “Health-Care Rollercoaster: Don’t just go along for the ride.”