Marketplace of Ideas Blog

Milwaukee Journal Sentinel columnist John Torinus identifies what should be done to salvage health care reform:

When attacking a complex problem, any manager worth his or her salt looks for the root cause of the problem. In U.S. health care, the number one problem is the runaway costs and prices. Hyperinflation in medicine caused the access problem. It's an economic model that is not working.

There are plenty of best management practices in the private sector that could lead to major savings:

• Lead with primary care to get serious about prevention and chronic disease management.
• Change the broken government and insurance payment systems that reward volumes of procedures instead of primary care and quality of care.
• Incorporate incentives so plan members take ownership of their own health and the associated costs. Third-party payment produces irresponsibility. No system can ever work without individual responsibility baked in.
• Make prices transparent and bundle them for an episode of care, so people can understand their bills and identify value.
• Make the quality of medical performance transparent so people know where to go for care.
• Search out and reward centers of value that deliver the best quality, services and prices.

All of these reforms would take huge costs out of the system, and then prices would follow. Theda Care in Appleton, which practices lean disciplines to drive out waste and errors, such as infections, believes it is the lowest-priced system in the state. It scores well in quality assessments, as well.

There is almost universal support for these fundamental reforms among leading thinkers in health care, so let's assume the voters in the land would take their advice, understand and agree.