Fixing health care in the U.S. requires policy change: Consumers First call to action

April 16, 2021 / By L. Gordon Moore, MD

Families USA ¹—a nonprofit, nonpartisan consumer health advocacy organization—pulled together a coalition called Consumers First, ² which issued a Call to Action:

“Consumers First has issued A Call to Action to consumer health care organizations, employers, labor unions, health care professionals, and allies across the nation to join in efforts to uproot the fundamental economic distortions in the nation’s health care payment and delivery system to ensure that the best health and health care are affordable and accessible for every person across the country.”

This call is based in part on the following points that are the lived experience of health care in the U.S.:

• 44 percent of people in a survey say they did not see a doctor when needed due to the high cost of health care.
• COVID-19 testing prices (for the same test) ranged from $20 to $850 per test at major hospitals.
• Fee-for-service (FFS) incentives continue to drive volume of services without regard to the value of those services.
• Under-funding of preventive and pre-emptive (primary) care results in missed opportunities with immense human and financial costs.
• In spite of massive advances in data and technologies, health care information sharing continues to be aspirational instead of meeting the essential needs of people.

I don’t think it’s a stretch to see that people, parents, unions, employers and health care professionals are coming together to express dismay. The U.S. health care system is wonderful in some ways, but failing us in others. When 44 percent of people say they are avoiding care due to cost, we have a problem. That we’re spending more on health care per person than any other OECD country AND people say they still can’t afford to go to the doctor, we have a problem. (see chart 1 and chart 2 below)

It doesn’t have to be this way. 

The Call to Action recommends policy changes that should make it possible to improve disease prevention, health promotion, reduce costs and improve quality.

Call to Acton policy recommendations:

1. Make health care more affordable by preventing further consolidation of health care markets and lowering health care prices.
2. Increase price and quality transparency to create a more efficient, fair and equitable health care system.
3. Improve health outcomes by shifting payment incentives to deliver health, reduce inequity and emphasize service value over volume.
4. Strengthen our system of primary care by investing in services that keep people healthy and prevent them from needing to access more expensive care settings.
5. Establish national data-sharing and interoperability standards to reduce waste and enable real-time coordination of services across health sectors.

The Call to Action expands on each of these policy reforms. We can do this.

Dr. Gordon Moore is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.

¹https://familiesusa.org/our-work/consumers-first/
²https://familiesusa.org/resources/consumers-first-2021-administrative-agenda-policy-solutions-to-strengthen-
the-infrastructure-of-u-s-health-care-payment-and-delivery/