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Thursday, November 5, 2020  Spokane, Washington  Est. May 19, 1883
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Opinion >  Guest Opinion

Dr. Francisco R. Velazquez: The future of health care reform

Dr. Francisco R. Velazquez

In my role as a medical doctor, I’ve seen the power of medicine to transform lives. And as a physician executive, I’ve had to pay close attention to the bottom line in the delivery of health care services. The individual patient and the regional health care system both require a delicate equilibrium of support, care and incentives to improve over time. Balancing considerations of patient cost and access while maintaining the systemic resources necessary to support research and innovation is no easy task. To move forward productively, we must take an earnest look at how to improve the core functions our health care delivery system and build on what we know works.

Improving our nation’s health care system is not very different from helping a patient become well. We must start with what works in the existing system, assess misalignments where they occur, employ reasonable remedies from evidence-based best practice, and scale up solutions that prove effective in creating better outcomes.

Ensuring that Americans with pre-existing conditions are provided for is one of the ways to maintain the continuity of care that patients need. As a doctor, I took an oath to serve anyone in need of medical attention. Our health care system should reflect that value also. Not only is it the right thing to do, but patients who see a doctor earlier can access more effective and less costly interventions instead of waiting until they are so sick they need to go the ER. Let’s end the debate over this common sense issue and reach an agreement or compromise to address this concern and let it become a part of the foundation our health care system is built upon.

Another objective we can all work toward is ensuring that every American has access to affordable choices in health care. One place to start would be to review opportunities to reduce out-of-pocket expense. Several options have been examined, and given the complexity of the federal cost-sharing reduction payments program, addressing this potential gap would make health care more accessible and affordable for millions of working families across the country. We have previous examples of bipartisan collaboration not only on this specific topic, but in many other areas of health care.

Finally, we are very fortunate to live in a country that produces the vast majority of new medical innovations and patents across the globe. From targeted cancer therapies to new medical devices, the tradition of life science discovery in the U.S. is something every American should be proud of. Not only does the industry create impactful, family-wage jobs, but its products improve the health and well-being of people the world over.

Creating the environment under which innovation can thrive is difficult in the best conditions. Discovering a new cancer therapy, for example, can take hundreds of millions – if not billions – of dollars in investment and require 10 to 15 years in development from research bench to the marketplace. Attempts at innovation in this space fail to be approved by the FDA nearly 95 percent of the time, so scientists are often having to start over or reconfigure their research in response to clinical trial results.

While the early stages of discovery are largely supported by government funding and angel investors, life science innovation becomes financially sustainable once a product becomes widely available to patients across the U.S. Much of this stability is attributable to national health care purchasers like Medicare and Medicaid.

Recently, there’s been a flurry of speculation, and news stories, around potential changes to these foundational programs. As an industry, health care accounts for about a fifth of the U.S. economy. Sudden alterations to the entitlement programs that underpin this sector would cause mass disruption for patients, providers and life science innovators alike. There are real questions about how shifts in reimbursement structures could affect rural providers in critical access areas already operating under narrow margins. The potential for adverse outcomes from hasty policy decisions aren’t answered by 130 character slogans on either side of the aisle, and deserve serious vetting before gaining legislative traction.

A good soundbite has never cured a patient. And just like addressing the needs of an individual patient, actual solutions to the challenges in our health care system will require thoughtful probing and care to ensure the best outcome. As a physician, but more importantly as an American citizen, I am optimistic that we will build upon our successes, learn from our mistakes, and apply the lessons learned to create an ever-improving health care system for all.

Dr. Francisco R. Velazquez, a physician executive, is the former president and chief executive of Pathology Associates Medical Laboratories (PAML) and PAML Ventures.

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