McAlester News-Capital, McAlester, OK

Opinion

October 13, 2013

Clancy: Many factors driving health care reform in America

Oklahoma is ranked ‘most challenged state of all’ in delivering for its citizens

ENID, Okla. — Dr. Gerard Clancy believes it will take about 10 years for Americans to adjust to the many reforms rolling out in the nation’s health care system.

Clancy, president of the University of Oklahoma-Tulsa, was keynote speaker at Enid Regional Development Alliance’s quarterly networking luncheon Thursday. The high level of interest in Enid was obvious by the number of listeners packed into the room.

The Affordable Care Act, with online insurance marketplaces going live this month, is not the only issue driving reform.

“It’s not just the health reform legislation that’s in play,” Clancy told the audience.

Many other factors are driving health care reform, including an aging population and a decrease in the physician supply.

“We have a huge increase in the number of people over 65 years old,” Clancy said.

In Oklahoma, 41 percent of physicians are 55 and over. Not enough new physicians are coming out of medical school to replace all the ones who will retire in a few years. The state of Oklahoma is ranked “the most challenged state of all” in terms of delivering health care to its residents, Clancy said.

Health care spending is increasing faster in America than in other nation.

“We’re getting poor outcomes for our health care dollar,” Clancy said.

Clancy also said the United States has the best health care available — for those who can afford to get it.

“When I think about health reform, I think there’s a lot of things we need to do besides this bill,” Clancy said. “We have great things that will help us, but they cost a lot of money.”

Employers are fed up with the cost of health care and are shifting more and more of the cost onto employees, Clancy said. Additionally, health information technology and high-tech health care are driving reform.

The ACA bill is the most recent of three federal health care reform laws. The earlier health reform laws were the American Recovery and Reinvestment Act of 2009 and the Public Health Services Act of 1944.

Several changes in the health care scenario have come about because of these pressures, Clancy said. New payment models reward quality of care instead of quantity of patients seen. Hospitals and physicians can be penalized for poor outcomes, such as a patient having to be readmitted to the hospital within 30 days of discharge.

“What health reform and the market are saying is, we don’t want to pay for volume anymore — we want to pay for value,” Clancy said.

Physicians, clinics and hospitals are having to come up with new ways to meet new demands.

“This is the part of the health reform that we’re not talking about,” Clancy said. “These are the things that worry us the most and keep us up at night.”

Clancy received the National Alliance for the Mentally Ill Community Psychiatry Award in 2002. He received the Oklahoma State Medical Association’s 2003-2004 Award for Community Service for development of a community partnership to improve access to care for the medically underserved.

Clancy writes medical textbooks and works across the nation to develop outreach psychiatric programs for those with severe mental illnesses. He teaches at the medical school and regularly sees patients.

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