The United States spent 17.3% of GDP on health in 2009, but ranks on 49th on life expectancy worldwide, patients receive the correct treatment just 55% of the time, and significant variability exists in the quality of care delivered. The contentious Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act, signed into US law on March 23, 2010 and March 30, 2010 respectively, were historic events paving the way to changing the US health care system to make it more equitable, efficient and effective. The challenge lies in bringing about the change needed. A 21st Century Roadmap for Advancing America’s Health: The Path From Peril to Progress, the 2nd report by the Commission on U.S. Federal Leadership in Health and Medicine, was published this week. Drawing on recommendations from working groups representing key areas in which progress is needed, the Commission put forth a comprehensive strategy:
• Re-engineer America’s health care system: Invest in health technology ($19 billion has already been committed to investment in health information technology with the American Recovery and Reinvestment Act) to maximize value and minimize waste; lower costs by adopting new value-based payment methods, promoting team-based medicine, strengthening primary care and conducting comparative effectiveness and health systems research.
• Advance public health: Focus on public health, prevention of illness, and encouragement of healthy lifestyles: more than 75% of health care costs in the US result from chronic diseases, many of which are preventable.
• Promote global health and health diplomacy: Increase federal investments in global health, as global health has humanitarian, economic and national security implications. Currently federal investments in global health account for less than 1% of the US budget.
• Strengthen US medical and public health research: Increase the funding base for scientific research in biomedical and public health research, as it is “the foundation for all health and medical interventions, the cornerstone of health care reform efforts, and an engine of economic and societal progress.”
The Commission acknowledged that improvement in health needs much more than investments in health technology, access to care, measures to contain costs or health insurance coverage for all citizens – that commitment to change is needed at every level: from government & policy-makers, to health care and public health workers, to individual citizens. Whether the new legislation, increased investments, and new technology will achieve the goal of advancing America’a health depends greatly on how that change is managed. Developments so far are promising....