MD Anderson Is Not Immune To The Ravages Of Health Care Reform

By

Leonard Zwelling

What is health care reform anyway?

My friend the American Enterprise Institute’s Norm Ornstein says, “Everyone’s idea of health care reform is the same. I pay less.”

That’s pretty much it.

Health care reform in America could be about shrinking the amount of unnecessary expenses that are poured into the health care system, at least twice what the rest of the world pays per capita. But that would mean someone in the health care-industrial complex would make less money. No one is for that even though it is the most important of all reforms.

The next thing it could be about is freezing the amount spent or at least lowering the rate of medical inflation (price increases) while improving its quality. Then we would be getting more value for the same expense. But who knows how to measure quality and what is it anyway?

To some quality is free parking at the doctor’s office. To others it’s having a Starbucks in the basement of the doctor’s building. What about the latest issues of People Magazine in the waiting room?

Oh, you actually care how good the health care is? What’s your metric? When I had by-pass surgery all I wanted out of St. Luke’s was to get out alive. You get my drift.

So at least let’s agree that everyone should have access to decent care. Well, what is meant by decent care?

In health care, the objective measures are few—expect for dollars—and the criteria are variable for each health care consumer.

At MD Anderson, it is said, the care is of the highest quality. By whose metric? US News and World Report? The real vital metric for a place like Anderson is to prove that the outcome provided by the care administered is superior to that quality from care administered elsewhere. But, is that true? How do you know?

Care at Anderson is sure pricey, especially if you are paying with your own money. And as for access, the traffic in the Texas Medical Center has generated the assumption that having MD Anderson sites around the city (“we’ve got you surrounded”) would be a good idea, but is the care at these other sites the same as that at 1515? Who knows?

If the GOP’s plan is passed, it will adversely affect Anderson because people being cared for now and whose insurance is covered by Medicaid may lose access to the cancer center. Many safety net and academic hospitals are likely to be adversely affected by this bill.

Don’t kid yourself. MD Anderson is not immune from the effects of the newly proposed replacement for the ACA. And if that replacement is passed, it will take some additional scrambling to keep the place in the black. Think more salary on grants and a greater push to fill those clinic templates.

The coming of a new president is surely a reason to celebrate. But let’s not take our eyes off the ball. The forces in American health care do not favor places like Anderson. The next president will have to understand that and make the correct strategic decisions to keep the doors open and the knowledge flowing. Along with Caring, Discovery and Integrity, a core value may soon include Frugality.

Leonard Zwelling