A Crack in the Wall

December 15, 2011
9:46 am

If there ever seemed an issue, in today’s political environment, upon which Democrats and Republicans would never meet in the middle, it is Medicare reform.  This is always particularly true in the months leading up to an election.  It’s just too easy to portray any new idea to make the Medicare program more affordable or sustainable as a dangerous threat to vulnerable seniors.

That’s why it’s impossible to overstate the significance of Senator Ron Wyden (D-OR) and Representative Paul Ryan (R-WI) reaching across the aisle and joining together to offer a meaningful Medicare reform plan.  This development has probably caused no small amount of heartburn in some political and campaign planning circles, but for taxpayers, future Medicare beneficiaries and the program itself, this is a very positive step.

We’re not going to try to comprehensively analyze the Wyden-Ryan plan right now in this space.  Both lawmakers have, in fact, said that they won’t offer legislative language until after the 2012 elections.  In broad strokes, though, the concept offers a sustainable path for Medicare’s future, offering beneficiaries a fixed federal contribution that can be used to acquire coverage from either conventional fee-for-service Medicare or a selection of competing private plans.  As we’ve said at the Healthcare Leadership Council, in advocating this type of approach, competition will drive greater innovation, quality and value.

The news today, though, is not the details of the plan, but the fact that Ron Wyden and Paul Ryan have opened up a crack in the previously impenetrable wall between the two parties on this issue.  If this gradually moves us to a place where we have more substantive discussions about how to maintain a viable Medicare program, and fewer 30-second “Mediscare” TV ads, then these two have made an incredibly valuable contribution.

Good News on the Workforce Front

December 07, 2011
1:15 pm

There are numerous concerns these days about the nation’s supply of medical professionals to meet America’s growing elderly population as well as the millions of citizens who will gain health coverage when the Affordable Care Act is fully implemented.  How will the healthcare workforce meet this rising patient demand?

We received good news this week regarding the supply of nurses.  A RAND study shows that the number of young nurses – registered nurses between the ages of 23 and 26 – has grown by 62 percent between 2002 and 2009.  This reverses a course projected back in 2000 by a study in the Journal of the American Medical Association, which said the U.S. would have a 20 percent shortfall in the supply of nurses by 2020.

Dr. Peter Buerhaus of the Vanderbilt School of Nursing (Colleen Conway-Welch, the nursing school’s dean, is a Healthcare Leadership Council member)  was one of the authors of the earlier JAMA study and told Nashville Public Radio that he’s no longer worried about a nursing shortage.  He credited more colleges adding nursing programs and successful initiatives raising awareness about personnel shortages and job openings in the nursing field.

Certainly programs like Johnson & Johnson’s Discover Nursing initiative have been extremely helpful in both pointing out the employment opportunities, available scholarships and job satisfaction in the nursing field.

This doesn’t ease all of our concerns about healthcare workforce shortages, but at least it’s a solid and important step in the right direction.

Fighting for Position in a Losing Game

December 06, 2011
12:53 pm

Vermont is number one.  Mississippi is number 50.  But, truth be told, every single state has reason for concern.

The United Health Foundation has issued its annual “America’s Health Rankings” report, showing a state-by-state ranking in overall population health.  The striking news this year was not that the New England states occupied six of the top 10 positions, but that the nation as a whole is not faring well.

The United report card showed zero overall improvement in America’s health status over the past year.  That’s the first time in two decades that our health has showed no upward mobility whatsoever.  In fact, over the past decade, the rate of improvement in the nation’s health status is 69 percent less than it was in the 1990s.

It doesn’t take much analyzing to find out the reason.  Obesity is up considerably and diabetes cases are escalating in number.  This concurs with what the Centers for Disease Control and Prevention has been telling us about chronic disease trends.

As Reed Tuckson of the United Health Foundation board said, the United States is facing a “tsunami of preventable illness.”

The good news is that there are initiatives being developed throughout the country to keep communities and workforces in better health and prevent the onset of chronic disease.  The Healthcare Leadership Council has chronicled a number of these in its HLC Wellness Compendium.  We shared this document with key staff members on Capitol Hill at a briefing last week.

The better news will occur when we see policymakers taking these successful examples and finding ways to extrapolate them to help larger populations.

We can still hope that, in the future, when states are competing for placement on the United rankings, that the entire competition will be taking place on a higher plane of healthiness.