The mission of Prognosis is to explore the nexus at which healthcare policy meets healthcare practice and how one affects the other. This blog makes readers more aware of the innovations taking place in healthcare delivery, financing and technology and the types of public policies that will encourage further progress.
Healthcare In Focus is a public education initiative of the HLC, created to promote a constructive dialogue about the state and future of American healthcare.
Two congressional town hall meetings this week. At one event, a question was raised. At another, a couple of hundred miles to the south, that question was answered, but not in a way that should please advocates of meaningful health reform.
In Newark, Delaware, at a constituent gathering hosted by Representative Mike Castle (R-DE), Dr. Nicholas Biasatto, the president of the Delaware Medical Association, wondered why health reform legislation that has emerged from House committees contains no mention of medical liability reform. As Dr. Biasatto pointed out, an estimated $70 billion to $127 billion is spent each year on defensive medicine – tests and procedures that are performed primarily as protection against the possibility of litigation.
Had Dr. Biasatto been in Alexandria, Virginia, he would have heard a candid answer to his question from former Vermont Governor Howard Dean, who was taking part in a town hall meeting with Representative Jim Moran (D-VA). Governor Dean said, “The reason tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everyone else they were taking on, and that’s the plain and simple truth.”
Governor Dean is to be commended for his candor, but his answer casts a spotlight on a glaring omission in the various health reform bills working their way through Congress. Read more
The month of August has shown us that America is a divided country when it comes to health reform. There is genuine anger being demonstrated at town hall meetings at the idea of healthcare legislation that would increase the size and scope of the federal government. By the same token, interest groups pressing for a government-run health plan are ratcheting up their rhetoric as well.
Given this growing chasm in public opinion, there is legitimate reason to be concerned over a report this week in The New York Times that some Senate Democrats are “fleshing out plans” to use budget reconciliation rules that would require only 51 votes, instead of the usual 60, to pass health reform legislation.
It has been said many times that using reconciliation rules would be akin to droping a nuclear bomb on the long-cherished tradition of comity and cooperation between Democrats and Republicans in the Senate. I think the reverberations, though, would likely go well beyond the walls of the U.S. Capitol. The resentment felt by many citizens would only intensify if a measure the magnitude of health reform was enacted by one-party rule, using Senate procedures outside of the normal method of dealing with major legislation. Read more
For all of the criticism of healthcare in the United States, something’s obviously working right. According to the Centers for Disease Control and Prevention, life expectancy in the U.S. has now reached nearly 78 years, an all-time high. There’s no mystery as to the leading reason for this gain.
Today’s healthcare professionals are constantly finding more effective ways to combat deadly diseases. The death rate from heart disease dropped five percent in 2007. The cancer fatality rate fell two percent. The HIV death rate saw its largest one-year decline – 10 percent – in a decade.
As the blog Serious Medicine Strategy put it, “Are we overweight, too many of us? Yes. Do many or most of us not get enough exercise? Yes. But are we still doing better? Yes. So, let’s be careful about pulling apart the system we have.”
Long before congressional committees began debating health reform legislation, Ascension Health, a Healthcare Leadership Council member and the nation’s largest non-profit healthcare system, had developed a set of principles on how to move toward a high-quality U.S. healthcare system that offered affordable coverage for all Americans.
Ascension CEO Anthony Tersigni has been a leading, insightful voice in the health reform debate and, therefore, I took great interest in an interview with he and Ascension’s Chief Advocacy Officer Susan Nestor Levy conducted by Kaiser News Service. Read more
I’ll say once again that the government option controversy is taking up so much space in this debate that we’re losing sight of the other essential objectives of health reform. We need legislation that will increase access to health coverage and that will incentivize care coordination between providers. We need to align health care payments with quality and value. We need to find ways to use comparative effectiveness as a tool to improve clinical performance. These are issues that will affect every American patient and health care consumer, but they’re not getting the attention they deserve.
President Obama said at one of his recent town hall meetings that the government option is just a “small sliver” of the health reform debate. HHS Secretary Sebelius said the Administration, while it still prefers a government option, needs to be open to other workable coverage alternatives. Read more
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