This week in health care

This was the week that epic events were scheduled to happen in regard to health care on the national, regional and local levels.

By Thursday, the Supreme Court will in all probability finally have ruled on the constitutionality of the federal Affordable Care Act passed in 2010. That’s the big enchilada, involving the basic structure of an industry that encompasses a sixth of the gross national product. The headlines generated by the Supreme Court decision are expected to surpass those about the British Golden Jubilee and the celebrated Kardashian divorce put together.

On Tuesday, a web-based seminar took place in regard to an ambitious Hudson Valley-wide initiative to advance coordinated, comprehensive primary care. Our region is the locus for a federally supported pilot program for the reorganization of this portion of national health care. According to THINC (Taconic Health Information Network and Community) in Fishkill, at least two-thirds of all Hudson Valley primary medical practices have now adopted electronic health records (62 practices, 182 locations, 831 providers). But their clinical integration into a broader system of health care is only a little beyond its infancy.

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And this was of course the widely anticipated week that HealthAlliance of the Hudson Valley (HAHV) would hold two meetings, one in Kingston on Tuesday and the other in Saugerties on Thursday, to inform and to listen to public input on the consequences of the local integrated healthcare system’s serious financial circumstances. Concerned that premature disclosure of its alternatives might exacerbate uninformed community concern, HAHV management exhibited some degree of reluctance to hold public meetings now, but they did agree. With the community already forewarned that drastic change was likely to be necessary, the meetings were widely anticipated. The Daily Freeman on Tuesday outdid itself with the zippy headline “Forum today on hospitals in Kingston,” second in size to that for an accident story, “One dead, two injured.” The Freeman promised to livestream the HAHV event.

Like patients scheduled for serious but necessary surgery, locals involved in the health care industry looked forward to the cataclysmic events of this week with a combination of relief and dread. Sorting out what happened is likely to take months.

Inevitable change

Three conclusions seem obvious. After more than 60 years of inaction, Americans seem to realize that the cost of not completely overhauling the healthcare system is greater than that of overhauling it. Health care is a subject of interest to the entire community.

Secondly, information management is transforming the world of health care, making an unprecedented degree of coordination among providers, payers and patients possible. More parts of the expensive, sprawling and uncoordinated system that is the healthcare industry are being scrutinized and reformed. The process will continue, no matter what happens with HAHV and, in fact, with Obamacare.

Finally, now that the outlines of what’s likely to happen to a couple of the big imponderables, one national and one local, are becoming clearer, there is likely to be an acceleration of attention to solving the huge problems of the industry. The trend toward abandonment of the traditional payment-for-services model, which discourages integrated care, is likely to continue. No matter who wins the next national election, America will turn to some other system.

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