Changing health care for the better
Leaders on Capitol Hill are about to turn their attention to health care reform again. While “repeal and replace” has the most attention, what is at stake is beyond the fate of the Affordable Care Act. We have the opportunity to strengthen health care for the future and create a more effective and efficient system for all Americans.
While reducing health care costs is an important goal, cutting Medicaid funding or reducing essential benefits alone will not reduce health care costs in the long run. If we really want to transform health care, we have to change the way it is delivered.
If we examine what influences health care costs, one of the most significant drivers of costs is not necessarily coverage, but the fragmented nature of our health care system. Today, close to 5 percent of the population consumes about 50 percent of health care spending. Data and experience have shown that people are more likely to use excessive and costly services in the absence of access to the right type of care. This explains why so many use costly emergency room visits to address health conditions that have spiraled out of control. This is particularly true for the millions of Americans who have mental health or substance use disorders.
Approximately one in five Americans has a mental health disorder. If a person loses mental health coverage under Medicaid, we will compromise their overall health and well-being. We also jeopardize their ability to hold a job, maintain their home and keep their children and increase the likelihood that they will end up in a hospital or prison. Untreated depression is considered the costliest condition for employers, responsible for the equivalent of 27 lost work days per year. The costs of all these circumstances are far more than the cost of community-based care.
The same can be said of substance abuse. Untreated substance abuse can lead to infection, heart disease, liver disease and death. Too many people with addictions land in emergency rooms or jails, and the cost is astronomical. A 2016 report from the U.S. Surgeon General showed that the yearly annual economic impact from the misuse of prescription drugs, illicit drugs or alcohol in the United States is $442 billion.
Behavioral health treatment services can impact the costs of all these areas – in most cases for far less than the cost of an emergency room visit. If we can focus on improving patient outcomes, we will be making a critical investment in healthier, more self-sufficient citizens. For every dollar spent on improving treatment for just depression and anxiety, the return on the investment is more than $4 in increased productivity and health for our citizens.
This is why we cannot roll back essential health benefits – particularly coverage for mental health and addiction disorders. Removing mental health and addictions treatment from the essential health benefits package will simply shift costs from health care spending to other more expensive arenas – all without addressing the health needs of the population. Instead, we need to recognize and reward health care providers who help their patients achieve the best quality outcomes.
As our elected officials return to Washington, D.C., it is our sincere hope that they look beyond cuts to coverage and toward the ways health care is delivered. Reform that rewards outcomes and value will be the true driver in curbing costs, creating a healthier future for us all.
John G. Markley, MBA, is chief executive officer of Centerstone Illinois. Centerstone is one of the largest behavioral health care providers in Illinois, with more than 50 years experience of serving children, youth, adults and families. Centerstone offers skilled counseling, psychiatric and medical services, substance abuse treatment, and services for adults with developmental disabilities, with service centers in Franklin, Jackson, Williamson and Madison counties.