Healthy Vision 2010: The Treatment


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

  • Texans must take more individual responsibility for the financing of their employer-provided or individually owned health insurance products.

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 Safety

  • Texas health care professionals must support an environment conducive to reporting preventable errors and developing strategies to prevent and correct them.
  • 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 possible.
  • 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 individual desires.
  • Texans must do everything possible to prevent needless pain.

More Healthy Vision 2010

The Treatment: Accountability, Efficiency, and Effectiveness

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 confidence.

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.

Accountability . 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 ethics.
  • Patients must understand the financial and medical consequences of their lifestyle choices and their health care decisions.
  • 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 containment.
  • 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 professional services.

Efficiency . 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 health.

  • 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 services.

Effectiveness . 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; and 
  • We must provide physicians with access to valuable data that allow them to compare themselves with their peers and maintain continuous quality improvement.

Next: Goal #1: Accessible and Affordable Health Care for All Texans