Reforming America’s healthcare maze of intricate regulations, excessive costs and poor management will help ensure prosperity and better outcomes and provide for the well-being of future generations, writes Marc S. Ryan in The Healthcare Labyrinth.
Ryan is president of MHK, a healthcare software technology firm for health plans and pharmacy benefits managers. He also served in health-related, high-level executive and advisory state positions and on the federal State Pharmaceutical Assistance Transition Commission.
Aiming to demystify healthcare, the author begins with its historical basis, compares the U.S. with other countries and explains the role of regulators. He examines what led to the dysfunction of U.S. healthcare, then provides concrete examples of solutions, ranging from using modern medical technology to provide safe outpatient and home care to suggestions on how to enhance Medicare’s solvency.
As he breaks down the complexities of insurance, he includes consumer-related tips on ways to better navigate the system: how to choose plans (including considerations regarding Medicare and Medicaid and Obamacare offerings); overcome billing problems or request an insurance drug formulary “tiering exception” (to have a needed drug placed in a lower-cost tier) and more.
Ryan also discusses positive trends that could move healthcare toward a new paradigm, suggesting that a system that focuses on wellness and prevention and provides universal coverage with attention to costs could help. Comprehensive change can occur, he adds, from a combination of public-private partnerships, better Medicare accountability, an overarching care-management focus, development of a national long-term care policy and better access for all with an eye to reasonable self-accountability.
This is not a quick self-help read. The author’s use of healthcare terminology and concepts, although clearly explained, can be challenging for those unfamiliar with the advanced subjects discussed.
Still, those looking for better ways to navigate the system will find helpful suggestions, particularly relating to insurance, and a better understanding of the healthcare system’s fundamentals, along with possible steps for reform.
