Sylvia Romm, MD, MPH’s Post

My good friend Julia Hunter PhD recently raise a call to action to leaders in the space industry to change their practices to prioritize sustainability. If you are interested in what we are doing in space and how to make that work sustainable, this is a must-read!

Today, I'm excited to share a project that's not just innovative but personally important to both Iyah Romm and me –Nema Health. This venture, created by and nurtured over three years by the incredible CEO Sofia Noori, MD MPH stems from a shared understanding of trauma, influenced by so many of our experinences and the challenges witnessed during the pandemic. Nema is a collective response to the complex world of PTSD and trauma care. It's a fusion of professional dedication and personal commitment, aimed at transforming the way trauma is addressed. As an investor, I’m inspired by Nema’s incredible team, united in the vision to make a real difference in mental health. Stay tuned for more about Nema's journey and impact! Well done team! #MentalHealthInnovation #TraumaCare #HealthcareChange #Nema #PersonalJourney

Towards Universal Coverage: Legislative Steps that Could Propel the U.S. Healthcare System As we envision the future of U.S. healthcare, universal health insurance coverage emerges as a pivotal goal. But what policy changes could catalyze this transformation? Let's explore potential legislative reforms that could help achieve universal coverage. 1️⃣ Single-Payer System: One approach is a single-payer system, wherein the government finances healthcare for all residents. While a significant shift, this could simplify the system and increase accessibility. 2️⃣ Public Option: A public health insurance option could compete with private insurers, leading to lower premiums and increased coverage. This would preserve choice while expanding access. 3️⃣ Medicaid Expansion: Broadening Medicaid eligibility could extend coverage to millions of low-income individuals, increasing healthcare accessibility for our most vulnerable citizens. 4️⃣ Subsidy Increase: Boosting subsidies for individual market insurance could make coverage more affordable for middle-income families, thereby reducing the number of uninsured. 5️⃣ Automatic Enrollment: Implementing policies for automatic or default enrollment in health insurance could ensure that more people are covered, especially those who currently slip through the cracks. We have an opportunity to build a more inclusive, equitable, and patient-centered healthcare system. The international community has shown us varied strategies for achieving universal coverage - it's time for the U.S. to carve its own path forward. Let's engage in a meaningful dialogue about these policy changes. What other strategies do you believe could pave the way for universal coverage? Let's hear your thoughts! #UniversalCoverage #HealthcarePolicy #LegislativeAction #HealthInsuranceForAll Sources: Comparing Health Insurance Reform Options: From 'Building on the ACA' to Single Payer, RAND Corporation Single-Payer Health Care — A Tale of Two Countries, The New England Journal of Medicine The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid, Kaiser Family Foundation.

Health Care Transformation: The Role of Individual Health Professionals Against Greed The tides of change are rolling in, and it is time for health professionals to anchor the ship. As stewards of care, we cannot stand silent in the face of the existential threat posed by unchecked greed in the U.S. healthcare system. We are called to act, to break the vicious cycle where greed begets power, and power shields greed. So, what can we, as health care professionals, do to usher in this transformation? 📢 Breaking the Silence: As Dr. Donald M. Berwick points out in his enlightening JAMA piece, silence is assent. We must vocalize our opposition to extortionate drug prices, coding games, excessive executive compensation, and unnecessary care. It is our duty to heal and protect our patients, not to silently witness their exploitation. 💰 Redefining Priorities: Our guilds and trade organizations should place the welfare of patients above the pursuit of higher payments. Let us rally for a shift in resources towards those who need them most, emphasizing patient protection over profit. 🏛️ Policy Advocacy: We should actively lobby for systemic change, encouraging our leaders to pass legislation that reins in greed. This includes patent law reform, coding and billing rule changes, price transparency, and more, as suggested by Dr. Berwick. 🔬 Social Responsibility: We must insist that our organizations invest in improving the true social determinants of health. Our hospitals should actively work towards mitigating the root causes of illness, injury, and disability. It is a challenging road ahead, but it is one we must walk together. Let's initiate a conversation around these potential strategies for systemic change. What steps do you believe we need to take? How can we work together to overcome the barriers in our path? Let's make noise. Let's advocate. Let's invest in our communities. Let's transform our healthcare system! #HealthcareHeroes #SystemicChange #HealthcareReform Source: Salve Lucrum: The Existential Threat of Greed in US Health Care, JAMA, 2023.

Gleaning from Global Best Practices: Crafting a High-Performing U.S. Healthcare System In a quest for a more efficient, equitable, and patient-centered healthcare system, we don't need to reinvent the wheel. We can learn from high-performing countries worldwide, tailoring their successful strategies to the U.S. context. Here's how: 1️⃣ Cost Transparency: Germany is renowned for its standardization of healthcare costs, enhancing price transparency and fairness. A study in JAMA underscores that such transparency can lead to reduced healthcare spending. Can we borrow this idea to empower U.S. patients and promote competitive pricing? 2️⃣ Value-Based Care: Sweden's healthcare system excels in value-based care, prioritizing patient outcomes over volume of services. A report by Health Affairs emphasizes that adopting a value-based approach, like Sweden's, could realign our incentives and revolutionize American healthcare. 3️⃣ Preventive Care: Japan's preventive care measures are a cornerstone of their health system, resulting in the highest life expectancy globally. The CDC points out that such preventive services are not only cost-effective but also lifesaving. How might we adopt Japan's preventive care model to improve U.S. health outcomes? We attempt each of these in the US, but we are not able to execute any of these points as well as the countries that I’ve named. However, the results from these countries show that a workable blueprint for a successful healthcare system is out there, and it's high time we take a page from these global success stories. As healthcare professionals, policymakers, and patients, let's engage in this vital dialogue and chart our course towards improved healthcare. Your insights and experiences are invaluable. Which strategies from other countries do you think could help reform U.S. healthcare? Let's discuss! #GlobalHealthcare #HealthcareReform #ValueBasedCare Sources: "Association Between Availability of a Price Transparency Tool and Outpatient Spending", JAMA "Moving from Volume to Value in Health Care: The Work Begins", Health Affairs "Preventive Health Care", CDC

Urgent Call for Systemic Change in US Healthcare My fellow healthcare professionals, advocates, and influencers, it is no longer a question of if, but rather when, we must overhaul our healthcare system. The urgency for systemic change in US healthcare is indisputable to those that are looking at the unsustainable costs of the system for the poor results it creates. Let's consider the facts: Despite commanding the highest healthcare expenditure globally (Source 1), our performance on key health indicators continues to trail behind many of our high-income peers. From preventable hospitalizations to infant mortality rates, the statistics are sobering and unacceptable. Furthermore, our current model underscores a glaring disparity in access and outcomes. Racial and ethnic minorities bear a disproportionate burden, a clear testament to the need for more equitable healthcare (Source 2). Moreover, an entrenched profit-centric model, powerful insurance companies, and a pharmaceutical industry that often prioritizes revenue over patient need have resulted in skyrocketing costs without corresponding improvements in quality (Source 3). This can no longer be the status quo. Systemic reform is an absolute necessity, not a luxury. Let's envision a healthcare system that is efficient, equitable, and truly patient-centered. We must advocate for change at all levels - policy, practice, and perception. I invite each one of you to join this dialogue. How do you perceive the pathway towards reform? What strategies can we implement to create a healthcare system that serves every American equitably? Your voices, ideas, and actions matter more than ever. Together, we can shape the future of US healthcare. Let's stand for change. #USHealthcare #HealthcareReform #TimeForChange Sources: "Health Spending Explorer," Peterson-KFF Health System Tracker "Health Disparities by Race and Ethnicity," Center for American Progress "Healthcare Profits over Patient Need," Journal of Medical Ethics

How the Pharmaceutical Industry Fuels US Healthcare Costs As healthcare professionals, we need to decisively address a major driver of soaring healthcare costs in the US - the pharmaceutical industry. Our patent system, while designed to incentivize innovation, too often breeds monopolistic practices. Exclusive rights granted to drug manufacturers lead to unfettered pricing power (Source 1). Let's challenge this system and foster innovation without compromising affordability. The lack of stringent price regulation is a glaring anomaly of the US healthcare scene. The liberty pharmaceutical companies have to set their own prices without competition or governmental scrutiny is a recipe for unsustainable cost escalation (Source 2). We need effective regulations that protect consumer interests. Direct-to-consumer advertising, a practice largely unique to the US, encourages the consumption of higher-priced drugs (Source 3). It's high time we review this strategy - should marketing ever override patient needs? And let's not forget Pharmacy Benefit Managers (PBMs). These intermediaries, while ostensibly streamlining the negotiation of drug prices, often contribute to price hikes (Source 1). Increased transparency is a must. Colleagues, it's time we take a stand. Let's leverage our collective influence to advocate for systemic changes. How do you propose we tackle the high cost of prescription drugs? What potential reforms do you envision? The future of an efficient, equitable, and patient-centered healthcare system relies on our actions. Share your thoughts, and let's incite change together. #USHealthcare #PharmaCosts #HealthcareReform Sources: "The High Cost of Prescription Drugs in the United States," JAMA "Why Are Drug Prices So High in the United States?" BMJ "Direct-to-Consumer Advertising in Oncology," The Oncologist

The Insurance Influence: How Insurance Companies Impact US Healthcare Let's bring into focus a pivotal player in our healthcare landscape - insurance companies. Their role in dictating healthcare costs and outcomes is considerable and worth unpacking. Insurance companies negotiate prices, decide coverage limits, and determine out-of-pocket costs. While these responsibilities are essential to maintain the solvency of the healthcare system, they can also lead to inflated healthcare costs and inequitable access to care (Source 1). For instance, research has shown that different private insurers often negotiate wildly different prices with hospitals in a dance between the two to get the highest margin for themselves. The costs of higher margins are then passed onto patients (Source 2). Could more stringent price regulation be a solution? Moreover, insurance coverage is known to impact health outcomes. Those uninsured or underinsured often face barriers to necessary care, leading to poorer health outcomes (Source 3). How can we ensure that insurance expands access, not limit it? Lastly, let's talk about the role of 'prior authorization,' a tool insurance companies use to control costs. While effective in theory, it can delay care and increase administrative burden for physicians (Source 1). Can we streamline this process to eliminate barriers? These are just a few examples. Now, let's turn the mic to you. What do you think? What is the role of insurance companies in contributing to a more efficient, patient-centered healthcare system? Join the conversation. Let's put our collective minds together to inspire change. Together, we can make a difference. #USHealthcare #HealthInsurance #HealthcareReform Sources: 1. "Health Insurance Coverage and Health — What the Recent Evidence Tells Us," New England Journal of Medicine 2. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics 3. "Uninsurance and its Consequences," National Academies Press

I think it’s important to understand specifics of other healthcare systems in order to understand what we could also achieve in the US. So I’d like to shift our gaze globally and engage in a thought-provoking comparison between the US healthcare system and a world-leading counterpart - Switzerland. A report from The Commonwealth Fund ranks Switzerland first in healthcare performance among high-income countries, while the US sits near the bottom (Source 1). Why the stark contrast? Is there something we can learn? Let's take a deep dive: 1️⃣ Universal Coverage: In Switzerland, health insurance is mandatory for every citizen, ensuring all can receive necessary care (Source 2). Conversely, in the US, almost 30 million people remain uninsured (Source 3). Is this the first step to closing the healthcare gap? 2️⃣ Cost Control: Switzerland uses cost-sharing and premium subsidies to ensure healthcare affordability while regulating drug prices and medical fees (Source 2). The US, on the other hand, struggles with soaring drug prices and unregulated medical costs. Can we adopt similar strategies to combat the crippling costs of care? 3️⃣ Patient Outcomes: Swiss citizens enjoy a higher life expectancy and lower infant mortality rate than their American counterparts (Source 1). These statistics speak volumes about the effectiveness of their system. Can we redirect our focus to prioritize similar outcomes? Here's the crux of it - are there lessons we can draw from Switzerland's model to enhance our own healthcare system? Chime in and share your insights, experiences, and suggestions. The first step to change is acknowledging the need for it. And it seems high time we did just that. #USHealthcare #HealthcareReform #TimeForChange #HealthcareComparison Sources: "Mirror, Mirror 2021: Reflecting Poorly," The Commonwealth Fund "The Swiss Healthcare System," Swiss Federal Office of Public Health "Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2020," National Center for Health Statistics