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.
Dr. Toby Cosgrove, the CEO of the Cleveland Clinic (a Healthcare Leadership Council member), is among the world leaders taking part in the Davos Economic Summit. Upon his arrival in Switzerland, Dr. Cosgrove was interviewed by the Fox Business Network. It’s an interview worth watching.
Dr. Cosgrove makes the important point that the health reform bills pending in Congress do a great deal to improve access for the nation’s uninsured, but they’re less successful at improving quality and especially at controlling costs. As he accurately states in the interview, an overlooked factor in rising healthcare costs is the growing problem with obesity that leads to increased episodes of chronic disease.
One of the best forums for diverse opinions on current healthcare issues is the National Journal’s Health Care Expert Blog. National Journal’s healthcare correspondent, Marilyn Werber Serafini, has assembled a large panel of contributors from associations, think tanks, Capitol Hill, academia and other circles to address the most important questions of the day.
This week, the question concerns the disarray that characterizes the current health reform process and, if lawmakers have to go back to the drawing board, what are the easiest, most cost-effective ways to make health coverage more accessible for uninsured Americans?
I’ve given my thoughts on the issue, which include subsidies for working families and more effective outreach to identify those who are eligible for public programs but not enrolled.
To read my submission as well as those from Congressman John Dingell (D-MI), New America Foundation head Len Nichols and others, go the National Journal expert blog.
Following Senator-elect Scott Brown’s victory in Massachusetts Tuesday night, there is no consensus yet in Washington as to what happens next on health reform. Opinions fall into a wide spectrum, from encouraging the House to pass the Senate bill as is to abandoning the effort altogether.
As I’ve said publicly and in an earlier post on this blog, I believe the Massachusetts outcome presents an opportunity for the congressional leadership to re-evaluate its direction on health reform, understand why it’s failing to gain public support, and develop a new bill that focuses on the essential elements of reform Americans and our healthcare system need. We need to fix health reform, not kill it.
Toward that end, it would be wise to solicit the opinions of those who have real expertise on the subject. Former Centers for Medicare and Medicaid Services administrator Dr. Mark McClellan had an insightful op-ed piece in yesterday’s Wall Street Journal that should not escape notice.
Dr. McClellan expands upon a criticism we’ve made at HLC regarding the bills passed by both the Senate and House. They don’t go far enough in the areas of delivery and payment reform – critical elements that health reform must include if we are to move toward a system that pays for value instead of volume of services. Dr. McClellan wrote:
“No one knows how to implement in a timely manner the long list of proposed pilots that might contribute to improving care and reducing costs on a national scale. While the proposed legislation does allow for providers to share in the savings of reform, it does so only in pilots that in Medicare’s experience can take a decade to set up, implement and evaluate, and that still don’t lead to replicable results. Consequently, it is far from clear that the reform bill will transform the health-care system without compromising quality.”
Dr. McClellan is correct. The federal government doesn’t have a strong track record of timely transformation of pilot projects into real-world programs and policies. We’ve already seen successful, innovative approaches by organizations like the Marshfield Clinic and Premier in CMS demonstration projects, in which they’ve shown that costs can be contained while still providing high-quality healthcare. We need to use those results we already have in hand to build workable delivery reforms.
The McClellan op-ed also addresses important issues like using health information technology to delivery critical information to clinicians in real time and encouraging healthy behavior by patients through health insurance premium incentives.
It’s an op-ed well worth reading and the kind of expertise we need as we try to get health reform back on track.
At this writing, voters in Massachusetts are going to the polls in a Senate election being watched throughout the country. If Republican Scott Brown defeats Democrat Martha Coakley in the bluest of blue states, there’s no question there will be enormous ramifications felt up and down Pennsylvania Avenue from the White House to Capitol Hill.
Already, some lawmakers and pundits are saying a Brown victory would be the death knell for health reform in this Congress. Congressman Anthony Weiner (D-NY) said in an interview on MSNBC, “I think you can make a pretty good argument that healthcare might be dead.” In his New York Times column, David Brooks wrote today that congressional Democrats wouldn’t dare pass the current health reform legislation in the aftermath of a Massachusetts defeat. He wrote, “It would be the act of a political party so arrogant, elitist and contemptuous of popular wisdom that it would not deserve to govern.”
Personally, I don’t want to see the Massachusetts results end any chance of improving our healthcare system during this session of Congress. Rather, I hope the congressional leadership sees this as an opportunity to improve the legislation and recast it in a way that can gain sustainable political and public approval. Read more
We hear it all the time. It’s a nonstop drumbeat. Healthcare in the United States is too expensive and too low in quality compared to other countries. Critics are constantly citing the World Health Organization which, in its most recent rankings, said the U.S. ranks 37th in overall healthcare performance.
In reality, though, what kind of healthcare do Americans receive? And would we really trade what we have for what is offered to citizens in other nations.
Dr. Mark Constantian, a reconstructive surgeon in New Hampshire, investigated that question and shared his conclusions in the Wall Street Journal last week. Dr. Constantian found that, when it comes to the factors that patients and healthcare consumers care about the most, healthcare in this country stacks up pretty well. Read more