3 Small Government/Big Government
Few partisan distinctions are as pithy and recognizable as the debate over the role of government: should it be big--using all of its strength and reach--or should it be small, leaving society and the free market to manage itself?
This question becomes more complicated in light of the fact that healthcare today is not just a consumer staple, but a national security consideration. Coordinating domestic healthcare with other governments requires some standardization and communication. That is why mentioning 'ICD-10' within earshot of a doctor gets the same reaction as nails on a chalkboard.
ICD-10 is the new, digital labelling index for just about any and all diseases, conditions, or other reportable observations in the medical world. In order to ensure everyone is using this same standard in order to be able to seamlessly communicate and collaborate globally, all U.S. hospitals and clinics have to update their coding to implement ICD-10 by October of 2015.
Not only that, but federal Meaningful Use laws require implementation of qualifying Electronic Medical Records (EMR) platforms starting in 2015 as well. The goal is to improve communication between providers, toward patients, and generally eliminate more of the preventable deaths and injuries that can result from such communication break-downs.
The effect has been thrusting a new, significant burden on healthcare providers everywhere. Between learning a new, digital record-keeping platform, as well as learning the language of a new record code, healthcare providers have a lot of federal pressure on their shoulders.
Without government intervention, such changes may well happen organically--but holding providers to a standard is more than just a consumer protection effort, it is a matter of national health and safety. Supporters of both approaches to coordinating the upgrade find themselves on a slippery slope, setting precedents that translate easily to other areas of policy.
4 Curing Cancer
The Precision Medicine Initiative is supposed to produce a cure for cancer. Current treatments, including screening for at-risk patients, would be a lot more effective if they didn't center on those already exhibiting (and suffering from) symptoms. But current treatments are already out of reach for the majority, based on narrow insurance networks under low-cost coverage plans.
Keeping insurance costs down--in order to get more payers signed up--was the goal of the Affordable Care Act, but it did so by putting most new enrollees in low-cost, small-network plans. ACA may expand access with its emphasis on prevention, primary care, and basic insurance coverage, but the most prolific disease of our time isn't cured by going to an annual check-up, and the best cancer hospitals don't fall under these types of limited networks.
Precision Medicine is expensive. Whether ongoing Republican efforts succeed in repealing Obamacare, or end up simply reforming and building it out, the map of provider networks are hardly going to swell just because a high-tech cure becomes available. These questions need to be answered, or all the research and gene therapy in the world won't make a difference for the tax-payers financing it.
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