Obama Urged to Overhaul Healthcare, Stat

In a letter to Obama, the Business Roundtable, the National Federation of Independent Businesses, AARP and the Service Employees International Union urge that a healthcare overhaul be a priority in the administration's first 100 days.

In their letter, the groups link healthcare reform with the nation's bleak economic conditions.

Obama made healthcare reform a central plank of his presidential campaign, pledging a sweeping effort to expand coverage and lower costs. But since his victory, he has not indicated how he plans to proceed with an overhaul that could cost hundreds of billions of dollars and spark an intense political battle.

In a national radio address Saturday, Obama made a general reference to healthcare reform, listing it with energy, education and tax relief as "key priorities."

Without Reform, a Health Care Bailout May Be Needed

At this year's 23rd Cerner Health Conference, Neal Patterson, CEO of Cerner Corp., pounded home the message that a health care bailout may soon become a reality.

According to Patterson, with costs escalating, the health care industry could very well be headed for a crash that could mirror - or dwarf - the $700 billion Wall Street bailout.

"The Wall Street bailout is a one-time number," Patterson said. "To bail out health care, it is not a one-time fix. When the bailout comes...it's going to be a very gloomy day."

He predicts that some hospitals and health organizations eventually may quit honoring government reimbursement programs - he used Medicare as an example - because the programs do not cover the costs of providing the service.

Can America's Perverse Payment System Be Fixed?

Mark Taylor, in the Sep. 26, 2008 issue of Hospitals & Health Networks magazine, asks this question in his article "Experiments in Payment". In it he discusses several new experiments in revising the payment system that are attempting to mitigate the current system, which he calls "a mess." As he and others see it, the current method provides little incentives to hospitals, physicians and other providers to work together, which in turn leads to overuse and duplication of services, as well as often neglecting preventive services and chronic disease.

The overriding principle in these experimental payments systems is to provide financial incentives based on quality measurements. But how do you measure quality? Is it strictly what happens during the patient stay, or thirty days after discharge, or 6 months after discharge? If your incentives are based on post-discharge results, how do you adjust if the patient does not follow the post treatment plan the physician or hospital designated? And if you bundle payments, how do you allocate the payment to the various providers? All tough questions.

While there is no question there needs to be remedies to the current payment system to provide incentives for delivering quality treatment, there is more important problems to address to get control of the healthcare system. First and foremost, preventive medicine must be emphasized. Political leadership, both in the public and private sectors, needs to get on the bully pulpit to drive this message and dollars must be invested to back up this message and change behavior.

Fraud must be reduced and the system must be redesigned so that malpractice considerations and insurance companies are not driving medical practice, which often includes unneccessary tests and procedures, which further increases the risk to the patient. We need to get some control over medical and pharmacutical research by addressing the question - at what point do we spend billions of dollars to add one or two months of life expectancy?


Healthcare reform has to be re-engineered from top to bottom. Experiments in the payment system are only one small step in the process.

HEALTHCARE REFORM TO HIT THE AIRWAVES

Viewers watching the upcoming nominating conventions will see a new advertising campaign advocating for healthcare reform, as reported in AHA News. Backed by some major healthcare associations, the effort is meant to provide impetus and urgency to tackle this major component [as much as 15% of GDP] of this country's economy.

Providers, suppliers, financial services companies, as well as consumers all have a stake in finding a new approach to making quality healthcare affordable and accessible throughout the country. The vested interests for maintaining the status quo might finally be challenged so that "business as usual" will no longer be the case when the next administration comes into office.

Record shattering deficits, an ill conceived war sapping our energy and resources, trade imbalances, a weak dollar, the crisis in the financial markets, global warming, energy independence, social security reform, are all huge problems that will advocate for time and money in the corridors of power in Washington. The healthcare industry will have to compete with all these issues to get the priority level and financial support needed in Washington to deliver our industry's services much more efficiently and effectively to a growing population that lives longer and places more demands on the industry.

Hopefully, the ad campaign will focus on heightening the awareness of and urgency to find better ways of delivering healthcare. Now is not the time to advocate any single approach as that will only enable the entrenched interests to divide and conquer and maintain the status quo.

Universal Health Care Is Possible -- With No Premiums or Deductibles

Universal Health Care Is Possible -- With No Premiums or Deductibles

Imagine a proposal for health care reform that guarantees free, high-quality health care for all Americans. No premiums. No deductibles. In this plan, the government insists that all insurers offer the same comprehensive benefits to everyone, including: office and home visits, hospitalization, preventive screening tests, prescription drugs, some dental care, inpatient and outpatient mental health care, and physical and occupational therapy.

If this sounds too fantastic to be true, you need to read Healthcare, Guaranteed: A Simple, Secure Solution for America by Dr. Ezekiel Emanuel. He offers a bold, refreshing plan for health care in America. The beauty of his proposal is four-fold: It faces up to the fact that reform won't pay for itself, and it offers a funding mechanism that is fair and efficient and could deliver high-quality care nationwide. It regulates insurers, forcing them to concentrate on quality. Finally, and perhaps most importantly, this plan insulates our health care system from the lobbyists who, today, have far too much control over our health care system.

Electronic Medical Records

In the June 24, 2008 issue of The New York Times, the editorial "Our Pen-and-Paper Doctors" bemoans the snails pace at which American doctors are converting to modern technologies, especially when compared to physicians from other countries. It goes on to say that without this conversion, the benefits of healthcare reform will become irrelevant.

Money, not enough of it, of course, is always to blame. But inertia is also at work here. For this country to improve the delivery of healthcare and reduce the financial burden of paying for it, not only must the institutional barriers that currently exist be broken down, but the healthcare paradigm must change to one of preventive care rather than curative care. Today, with the costs of drugs and technology so high, it often seems that profits drives the healthcare system. Since so much of healthcare is now in the hands of corporate structures [providers, suppliers, drug companies and insurers], whose only responsibility is to deliver quarterly profits to shareholders, the health of the nation is at risk. Yes, we can develop the greatest drugs and the most advanced research tools and technologies. But to really make a difference in the health of the nation, we must get back to the basics and change bad habits and live healthier lifestyles.

Institutional change is always hard. But until our country makes the committment to change the way we do things, which will require sacrifices from all of us, things will not improve. There are too many vested interests in staying the course.