Harvey Fineberg thinks the Affordable Care Act is a significant step in the right direction of health care reform, but he feels it doesn’t do enough to address the need for better care at an affordable cost.
Fineberg serves as president of the Institute of Medicine, an independent organization that provides unbiased advice on issues in biomedical science, medicine and health. He will speak at today’s 10:45 a.m. morning lecture in the Amphitheater on three issues he feels the United States must address to create a “culture of health.”
“We’re going to have to make our health care delivery system deliver even better value per dollars,” Fineberg said. “We need to establish the conditions under which people can help themselves to remain healthy, [and] we need to make the critical investments in new science and new technologies that will enable us to deliver even better preventive and curative care in the future.”
Fineberg said that Americans must solve all of these issues in order to successfully reform the health care system.
The Affordable Care Act changes the face of health care in the United States, he said. It will cover an additional 30 million people who previously had no health insurance. Parents’ insurance plans can cover their children in their 20s, and insurance companies are limited in their ability to deny coverage to people with pre-existing medical conditions.
But Fineberg said the law only fixes part of the problem.
“[The law] does not do enough to change the incentives of payment for medical services,” Fineberg said, “so that we move more toward a system that rewards outcomes rather than doing more things.”
The current payment model reimburses doctors for every test, examination or procedure performed. There is a built-in incentive to provide high-quality health care, but all the tests and procedures don’t necessarily address the actual health problem of a patient. Fineberg thinks quality — not quantity — of health care should drive America’s payment system.
Also, while the law encourages doctors and care providers to take more responsibility for people’s health, it doesn’t help people with chronic illness stay out of hospitals or bolster health provisions in the home and community.
A nation is only as physically and mentally fit as its people, and Fineberg thinks it makes sense to make health care a top priority. But he is disappointed that people are shortsighted in their discussion of health.
“We have a much bigger agenda ahead than the Affordable Care Act alone meets,” Fineberg said. “We’re getting bogged down in squabbles about parts of this act when we really should be focusing on the larger solutions to our health needs.”
Fineberg said that on both sides of the political spectrum, there is ranging support for solving health care issues. Congress seems unwilling to take on the job of compromise, he said, but its members need to work together to achieve real progress.
“The recent experience in Congress is not all that encouraging, but that’s the nature of a democracy: We get the elected representatives we put there,” Fineberg said. “They won’t be there forever.”