Ezekiel Emanuel, an architect of the  Affordable Care Act,  is “wildly optimistic” about the direction of the American healthcare system, reports FierceHealthcare. But he’s not particularly optimistic about technology’s ability to improve things a lot.

“Virtual medicine can’t change behavior by itself and our big problem is patient behavior change and physician behavior change,” he said at the AHIP Institute and Expo in San Diego.

He cited lower uninsured rates among adults and children and slower healthcare cost increases as critical good-news metrics since ACA’s implementation.

But, Fierce reported, he also acknowledged that the U.S. still lags behind every other developed country when it comes to cost control  and life expectancy, which he blamed on inefficiencies across the system. Fierce paraphrased him as saying that “Patients still get as many as 10 radiation treatments for a cancerous bone marrow lesion despite evidence that one is just as effective. For breast cancer patients, three weeks of intense radiation is just as effective as seven weeks, yet only one-third get the shorter duration.” He didn’t mention that ordering more and longer treatments make providers richer….

Fierce reported: “Perverse financial incentives, he argued, can be eliminated with a greater reliance in bundled payments and capitated—or risk-based—payments for primary-care providers.

“Providers that have successfully lowered costs and improved quality have done so using low-tech solutions, including care coordinators embedded alongside providers to help manage chronic care and an increased focus on behavioral health.”

To read the whole Fierce article, please hit this link.