Getting "Woke" at the National Medicare/Medicaid & Dual Eligible Conference

As I attend the National Medical, Medicaid & Dual conference, in Washington, DC, I’ve been able to hear from those who are involved in healthcare policy in the United States and what the future of it could look like.

The Medicare conference ended today with an address from Seema Verma, the administrator for CMS (Centers for Medicare/Medicare Services). Her message focused on some recent changes – such as:

• The ability for Medicare Plans to negotiate on Part B medications (those administered by healthcare providers-  usually in office)
• Loosening up of the ability for plans and agents to do more in sales and marketing meetings and events
• Request for legislation for Pharmaceutical companies to list drug prices in advertisement
• And now Medicare Advantage plans to offer telehealth services (the ability to speak to a provider either on a computer or phone for routine issues) to all members.

Ms. Verma said it took a while for this law to pass through Congress. The commercial markets have had telehealth services for about five or six years now. Medicare plans will roll this out in 2020.

Innovation isn’t the government’s strong point– what happens to this innovation if the government does take over healthcare for everyone?

How do we continue to find solutions for access to healthcare in rural areas? Access to a sick visit in urban areas can take a day or two to get an appointment, will government innovation solve this issue?  Access to social workers and other mental health providers is even more incredibly difficult - ask anyone in Columbia County, NY, for example.  

Telehealth has also taken off in mental health counseling – more people feel comfortable using this type of practitioner interaction. And, did you know – loneliness is a leading complaint from people now? It is becoming, yet, another epidemic. Having access to a mental health provider with just a call would be very helpful.

Yes, our system is broken. But does that mean we throw away the innovative solutions that are working? Or do we move forward and use best practices from the entire healthcare industry to pick up the pieces of our failing Medicare system?

Another session that got me thinking was a moderated tableside chat – between Lanhee Chen, Ph.D. from the Hoover Institute and Topher Spiro from American Progress. Topher was actually involved in the crafting of the Affordable Care Act under the Obama administration – the session was called, “Implications of the Midterm elections Including Medicare for All”. Pretty much out of the gate you could tell Dr. Chen was not a supporter of the ACA and Topher was. That said, they both had some really good points and both agreed (yes, if you can believe that folks agree in D.C.) that something has to be done. Perhaps a hybrid of employer, government and other solutions could end up being the solution to get more people covered in an affordable way.

What struck me most was a comment that Topher made. As he was working in the most recent defense of the ACA, a lightbulb went off, even though a majority of Americans, regardless of party – want access to healthcare, Republicans won’t sign on to fix the ACA aka Obamacare (aka Romney Care). A new bipartisan solution will have to come about to get buy-in. The ACA has too much history and negativity to be fixed. The phrase that comes to mind for me, “if you like your doctor you can keep them.” Can we, as a country, sit down and find a bi-partisan solution that can check off all these boxes?

The status quo is not working. 

The ACA has been picked apart so many times, it would sink faster than the Titanic at sea. Medicare doesn’t have enough money to sustain the current (and ever-growing) 130M beneficiaries. We need to stop yelling at each other, start talking and find a solution before it is too late. We have data, innovation, and experienced and intelligent industry professionals to make this happen.

Oh – and, go out and say hi to your neighbor, find a friend and fight off that loneliness. We need to come back together – not continue to push each other way. Everyone can use a shoulder to cry on at some time or just vent to – in this current world – it is even more important than ever.