All Texans must have ready access to affordable, high-quality
medical care. But that picture of good health is distant and
cloudy. The physicians of Texas strongly believe that the
intertwined triple guideposts of accountability, efficiency, and
effectiveness will set us on the road to good health.
Goal #1: Accessible and
Affordable Health Care for All Texans
Texas' health professionals must
collaborate with the business community, public and private
payers, employers, and employees to devise and test initiatives
that make health insurance companies offer coverage that is
more broadly accessible, affordable, and portable.
Texas must direct more of our precious
health care dollars into direct patient care.
Texas must build an adequate, home-grown
supply of appropriately trained physicians.
Texas must invest in the public health
infrastructure needed to protect the public in response to
natural disasters, epidemics, and bioterrorism.
Goal #2: Increased Prevention
and Personal Accountability
Goal #3: Wise and Effective
Use of Health Care Information Technology
Texas must devise a plan to bring
interoperable electronic health records (EHRs) to all physician
practices to save lives and save money.
Texas and the nation must encourage
public/private sector collaboration on a plan that will make
developing and using health information technology affordable
for physicians, hospitals, and providers.
Goal #4: Protect Patient
Texas health care professionals must
support an environment conducive to reporting preventable
errors and developing strategies to prevent and correct
A strong and fair Texas Medical Board must
protect the public safety while it brings new Texas physicians
into clinics, exam rooms, and hospitals as quickly as
Limited-license health care practitioners
must practice within the arena safely defined by their
knowledge, skills, training, and experience.
Goal #5: Humane and
Cost-Effective End-of-Life Care
- Texans must ensure that our spending on health care resources
during patients' final days, weeks, and months matches their
- Texans must do everything possible to prevent needless
Healthy Vision 2010
The Treatment: Accountability, Efficiency,
Unless we act swiftly, the ailments plaguing our health care
infrastructure today will overwhelm the delivery system tomorrow.
The road ahead will be rocky and rutted. Some of our actions will
not deliver on their promise for years to come; others are
essential first steps along the path to health.
Our goal is simple to define: All Texans must have ready access
to affordable, high-quality medical care. But a future of good
health lies far in the distance. Many with vested interests in
today's dysfunctional system will try to erect roadblocks and send
us on detours. Most Texans are unaware of the danger we face; few
can see clearly enough to take even the first step with
The physicians of Texas strongly believe that the intertwined
triple guideposts of accountability, efficiency, and effectiveness
will set us on the road to good health - and keep us moving in the
right direction when we falter.
Texas Medical Association's Healthy Vision 2010
is our prescription for a state for which we care and a people to
whom we have devoted our lives and our careers. In the long run,
this will cure what ails us.
. Physicians and our patients, hospitals and other health care
practitioners, health plans and government agencies all play vital
roles in maintaining and improving the health of the people of
Texas. Accountability demands that we all take responsibility for
those roles, reap the rewards when we fulfill them, and pay the
price when we do not.
- Physicians must continue to develop and follow science-based
care plans for our patients and for adhering to our professional
- Patients must understand the financial and medical
consequences of their lifestyle choices and their health care
- Employers must recognize that short-term investments, such as
workplace wellness plans, can become long-term benefits in their
employees' health, productivity, and health care cost
- Commercial health plans must stop shortchanging the
employers, employees, and taxpayers who purchase their products -
as well as the doctors and hospitals who provide critical
. For two decades, miraculous new technologies and medicines -
combined with our aging population's demand for more and better
care - have pushed health care costs well ahead of the broader
inflation rate. Frankly, health care is too precious, too
extensive, and too vital for Texans to allow a single dollar to be
wasted. We must devise and implement incentives to eliminate or
streamline those activities that do not contribute to better
- As President George W. Bush and his team have noted,
significant investment in new information technology is
imperative. Electronic health records can improve the quality of
care, enhance patient safety, streamline physician office
operations, reduce redundant services, and save billions of
dollars each year. These systems are extremely expensive,
however, and physicians won't be able to implement them if they
must bear the cost burden of these new technologies alone.
- We must allow those who buy health care services - either
indirectly through insurers or directly from doctors and
hospitals - to reap the benefits of the marketplace, constrained
as it is. As mass purchasers, government and employers need the
tools to better evaluate what they are buying and to demand a
more valuable bang for the health care buck.
- We must minimize administrative burdens for the great
majority of routine care and for physicians and providers who
have proven they operate within acceptable parameters.
- We must develop a more sophisticated system of health care
delivery that consistently dedicates adequate resources to the
comprehensive care management of patients with chronic and
complicated medical needs who need and use more health care
. From the individual patient's subjective notion of "feeling
better" to broad reductions in disease prevalence among an entire
population, the goal of health care is better health. An effective
health care system simply delivers better health. Given the cost of
care, effectiveness is inseparable from efficiency. Together, they
lead us to the goal of cost-effective care.
- We must devise health care financing systems that reward the
most cost-effective activity of all: prevention;
- We must train and disseminate enough doctors, nurses, and
other health care professionals - with the correct knowledge and
skills - to the parts of Texas where they are needed most;
- We must rely on proven, science-based clinical protocols that
improve health outcomes and reduce costs without turning the art
of medicine into an inflexible paint-by-number exercise;
- We must provide physicians with access to valuable data that
allow them to compare themselves with their peers and maintain
continuous quality improvement.
Goal #1: Accessible and
Affordable Health Care for All Texans