A Tipping Point in Healthcare Reform

A Tipping Point in Healthcare Reform


By Dr. Eric I. Mitchell

As healthcare reform has become the law of the land by a landmark decision of the Supreme Court, the care-count continues to grow daily.  This “count” is the number of American citizens who at age 65 years old become eligible for government medical care, which we know as Medicare.  Let’s quickly review the numbers: every 18 minutes, one hundred (100) Americans reach the golden age of sixty-five, that’s 7,999.9 persons per day or 2.92 million new Medicare recipients per year. With the post WWII baby boomers starting in 1946 and continuing until 1964, the seniors boom will continue for the next 17 years.

On July 1, 1966, Medicare, authorized by title XVIII of the Social Security Act, offered health insurance to almost all Americans age 65 or older.  That was 46 years ago and the paradigm and landscape of America healthcare has since shifted; life expectancy got longer, increase in chronic diseases, increase in obesity, increase co-morbidities, and many advances in medical technology, i.e. pacemakers, drug pumps, CAT scans, MRI’s et. Al.

The technology push in those four plus decade has also translated into a mindset of, “I want it right now”. When it comes to health, mental or physical, this can be good. The Electronic Medical Record (EMR) systems and the Cloud are working toward giving 24/7 access where needed. Many dollars have been directed into case management to also reduce the error ridden healthcare delivery system.

With the re-election of President Obama signed sealed and delivered November 06, 2012, the Patient Protection & Affordability Care Act (PPACA) is not slated for repeal. This national law now carries the promise of a new healthcare delivery system with a tipping point toward a new system and away from the office and institutional based delivery system of the 20th century.  Since the industrial revolution in America, doctors have cared for their patients behind the closed doors of the Doctor’s Office.  With the technology available today, patients and society no longer need or want to follow that closed-door model.  Today we must have the medical information where the patient and the provider can get it… any place, anytime, the cloud.

The health of the nation was front and center in the 2011 State of the Union Message: President Obama stated in his 2011 State of the Union Address that he wants to connect “every part of America to the digital age” within the next five years.  The President stated his vision of the future was one in which, “a patient…can have face-to-face video chats with her doctor.”

That time has finally come and none to soon. PPACA also, often shortened to the Affordable Care Act  (ACA) passed in March of 2010 and then upheld as the law of the land in June of 2012.  And lastly assured no attempts at repeal with the President’s re-election.  However, healthcare started to change long before the first and/or last vote in Congress because healthcare cost has been out of control for a long time.

During the 2008 electoral debates and elections, healthcare was the top agenda for America and the incoming President of the United States of America.  America has been debating the growing cost of healthcare over the last 20 years with no one person, institution or structure able to generate enough political capital to move the discussion of healthcare change beyond just talk, until now. The ACA is far from perfect, but it’s a start. Now we must continue to reshape the medical landscape to fit the paradigm of 2012 and beyond.  We as provider of healthcare should and must embrace the good parts and help to change the bad parts of this healthcare reform.

The Patient Centered Medical Homes (PCMH) and Accountable Care Organizations (ACO) are but two of the re-structuring formats being used to access risk and share savings in healthcare delivery going forward. Yet in 2011, one year after the PPACA became law only 19% of physician knew what an ACO was. There are now many mandates in healthcare organizations, i.e. hospitals, PPO, Practice management group, etc. where 3-5 hours of continuing medical education (CME) of what and how ACO’s will function are required.  This is a major practice adjustment, that has many healthcare professionals stressed over that seven-letter word, mandate.

Another critical part of the healthcare equation is to bring the practice of medicine into the electronic era with electronic medical records (EMR).  In 2011 a study of physicians show that 39% thought EMR would be helpful, 37% didn’t know if they would be helpful and 24% believed that EMR’s would hurt the doctor-patient relationship.

For that 24% that believe that EMR’s would hurt the doctor-patient relationship, I would take them back 13 years to the Institute of Medicine (IOM) study of 1999 that showed that in America’s medical arenas, 98,000 people died each year because of medical errors.  The IOM study showed medical professionals were working in silos of communities, hospitals and private offices where vital information about patients was not being shared and often times duplicated to the tune of 9 billion dollars of unnecessary testing per year, as outlined in that same report from the IOM, 1999.

The IOM with this information concluded that the United States is not as safe as it should be–and can be.  With at least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented. These statistics are estimates from two major studies from the IOM’s data.  Preventable medical errors in hospitals are now being addressed with a six sigma type approach for better patient outcomes.

Continued tomorrow.

About Dr. Eric I. Mitchell: Dr. Mitchell is the President of a budding telehealth company, TelMed Group.  Telehealth is not new to Dr. Mitchell, as he has a 20 year history in this type of healthcare delivery.  Early innovation was gained as a medical officer in the United States Army, creating video medical connections between the medical institution and the home aimed at preventing the impending healthcare disaster that would otherwise occur.


  1. […] Continued – Read Part 1 – Click Here Staying well is another area where new light is being shined. Workers seeking a better life outside of work have also been rewarded with the PPAC. The PPACA contains a number of provisions that encourage employers and health insurance providers to establish wellness programs. PPACA provides support for the creation and monitoring of new wellness programs. Section 4303 of the PPACA, instructs the Director of the Center for Disease Control to provide employers with technical assistance, consultation, tools, and other resources to evaluate employer-based wellness programs. State and local health departments can receive grants for providing public health community interventions, screenings, and clinical referrals to individuals between 55 and 64 years of age. Other elements, the Wellness Program Demonstration project will study the impact of incorporating wellness programs into the new state-sponsored health exchanges. […]