A Case Study for Payment Reform

May 29, 2009
3:42 pm

Daily journalism is an exercise of trying to fit an adequate amount of necessary information into a limited space or minimal time frame, whether it be print or electronic media outlets.  Thus, when it comes to healthcare, we are given basic message points – too many people are uninsured, healthcare costs too much, the United States doesn’t get the quality patient outcomes it should for the dollars spent – without ever discussing the reasons these problems exist.

That’s why I value articles like the one Atul Gawande wrote for The New Yorker in its current issue.  We have been making the case for some time now that the payment systems used in healthcare today are not serving patients, taxpayers or the healthcare system itself well.  Paying for volume of services does not lead us to an environment in which there are genuine incentives to keep patients well and to utilize the best, most cost-effective medical practices.

Gawande took these policy notions with him on a trip to McAllen, Texas where, in 2006, Medicare spent $15,000 per beneficiary, almost double the national average.  He conducted extensive interviews and gained a greater on-the-ground understanding of why spending disparities exist, and why the number of dollars Medicare spends in a particular location doesn’t necessarily equate to better health outcomes.  It’s well worth reading. Read more

Sharing Views On Expanding Access And Health Delivery Reform

May 27, 2009
3:37 pm

As I’ve mentioned before, the health reform process taking place right now differentiates itself from deliberations of the past through its openness and welcoming of diverse opinions.  Nowhere is that more apparent than in the work of the Senate Finance Committee, under the leadership of chairman Max Baucus (D-MT) and senior Republican Chuck Grassley (R-IA).  The committee, in recent weeks, has issued papers outlining the various policy options it is considering and has invited public comment.

The Healthcare Leadership Council has taken advantage of this opportunity to share our views — reflecting our diverse membership of leaders from all healthcare sectors — on how to achieve a health system in which every American has health coverage and in which policies are geared to incentivize coordinated care, evidence-based medicine, cost-effective practices, wellness and prevention.

You can read the Healthcare Leadership Council’s communications to the Senate Finance Committee here.

Who’s Against Health Reform?

May 21, 2009
1:09 pm

I received an interesting e-mail this morning – no, not offering me discounted luxury watches or the opportunity to move huge sums of money out of an African nation, but interesting nonetheless.   It was from one of the many interest groups here in DC, urging me to read their newest report on healthcare reform.  In the e-mail pitch, the group said, “Those who oppose health reform are choosing to maintain” a status quo defined by increasing numbers of uninsured Americans, escalating health insurance premiums, lack of health information technology and so on.

I couldn’t help but wonder, when this group talks about “those who oppose health reform,” exactly who are they describing?

As we get closer to congressional action on healthcare, we’re seeing some escalation in the shrillness of the rhetoric from outside groups – warnings about powerful forces who are out to stop health reform dead in its tracks.  Read more

The Personal Side of Health Information Technology

May 19, 2009
2:32 pm

I’m very happy for my friend Billy Tauzin, the chief executive of the Pharmaceutical Research and Manufacturers Association (PhRMA).  He has declared himself in good health after his 2004 surgery for intestinal cancer and subsequent internal bleeding problems from scar tissue.

I raise Billy’s good news because he reminds us that the national discussion about health information technology, which often stays mired in complex interchanges on regulations, technology and information-sharing standards, is really all about how patients’ lives will be bettered through the use of electronic medical records.

In an interview, Billy talked about the treatment delays and repeated procedures he endured because his different doctors and specialists didn’t have access to a universal set of electronic health records.  He said, “In some cases, I was almost in shock.  I couldn’t stand up or sit down, I was so short of blood.  We had to go through all of that every time, over and over again, when a simple digital record that I could have controlled and made available to those doctors and nurses in the emergency room might have gotten me help a lot sooner.” Read more

Biomedical Innovation and Health Reform

May 15, 2009
1:40 pm

An op-ed in the Wall Street Journal by John C. Lechleiter, CEO of Eli Lilly & Company, is recommended reading.  He makes some important points about how health reform needs to encourage biomedical innovation if we are to control costs by combating the economic impact of disease.  As Mr. Lechleiter writes:

Biomedical innovation is not incompatible with the health-care reform goals of universal access, quality improvement and cost control. On the contrary, without new, more effective medicines — along with new devices and diagnostic tools, and better treatments and surgical techniques — it will be impossible for larger numbers of Americans to obtain better health care at a manageable cost.