A Key Element to Meaningful Healthcare Reform

I have heard it said that a statesman is what describes a politician…twenty years later.  Well, it hasn’t been twenty years but for too long what has been absent from our political landscape is that time-honored gift of statesman-like oratory that speaks directly to the hearts of people listening and inspires good men and women into action. Through much of the last century, so much of what drew us together for common good was born of the statesmanship expressed in our politics by our politicians.

Thankfully, that seems to describe the spirit and promise offered by the incoming administration, and not a moment too soon as America grapples with the collapse, near collapse and dysfunctional performance of a lengthening list of essential industries.  The dysfunctional list, of course, includes much of American healthcare–our nation’s single largest industry and in desperate need of overall reform.

One of the first required reforms affects what, at first glance, may seem like an arcane technical procedure.  However, closer examination shows is an essential element of healthcare reform. The World Health Organization developed the International Classification of Diseases (ICD) and its member nations began using ICD-10 fifteen years ago. Meanwhile the U.S is still using ICD-9, the technologically outdated and systematically inferior coding language that is roughly 20 years past peak effectiveness.

ICD-10 is a more modern, more agile coding language that will improve efficiency, lower costs, reduce errors and save lives. Quite simply, the amount of diagnostic and treatment information that it can capture is exponentially higher than ICD-9. Analysis of the data ICD-10 will yield is central to understanding and managing medical costs and improving quality.

Outgoing HHS Secretary Michael Leavitt proposed rules for adopting ICD-10 in August with a three-year implementation timeline. When the new HHS administration of Tom Daschle’s and Congress get to work next year, it is vitally important that initial progress upgrading our nation’s medical coding system to ICD-10 continue as a priority. Because ICD-10 provides for advances in payment/reporting and health data analysis that are fundamental to healthcare reform domestically; but U.S. influence on global healthcare initiatives abroad will also be greatly enhanced.  Every day of delay pushes this country further away from expanding coverage for millions of uninsured Americans, raising the overall quality of care contained within that coverage and providing it at reduced costs to taxpayers.

Once online in the U.S., ICD-10 will support every basic element of healthcare reform, from research and education to indigent care and wellness. ICD-10 lends itself to emerging healthcare technologies and global interoperability.

The U.S. needs to find a 21st century strategy for navigating through what has become a hopelessly complex regulatory system. That is, the regulatory process must be legislatively modernized so as not to compromise the protections sought by imposing the regulations, but not so burdensome as to create critical delays that may be used as stalling tactics by opponents of reform. Support from the administration and from Congress can streamline the regulatory processes that protect us while enhancing our quality of life.

The promise of health care reform also holds the potential for economic expansion domestically and abroad. Strong public health policy helps to improve global health. Global health initiatives stimulate advances in medical research and diagnostic accuracy.

More than 100 countries now use some form of ICD-10 for clinical reporting. As the global standard for diagnosis classification, ICD-10 is becoming the world’s early warning system. It will be central to identifying and responding to the first signs of a global pandemic or bio-terrorist threat. ICD-10 is simply more able to capture public health diseases than ICD-9. Moreover, in a world susceptible to unknown or unforeseen medical threats, ICD-10 more fully captures information on international medical conditions and facilitates the sharing of best practices globally.

Now is the time for Congress and the administration to lend firm support to the timely adoption and implementation of ICD-10. The world cannot wait any longer for the U.S. to pioneer the new frontier of healthcare reform. The time for us to lead by example is now