Putting Patients First


Reform Schedule: Senators Baucus and Kennedy sent a letter to President Obama this week saying their committees plan to vote on comprehensive health reform legislation in early June, which means legislation could be sent to the full Senate for a vote soon afterward.

This is an extraordinarily ambitious schedule. The House also expects to send legislation to the floor for a vote this summer, with hopes for final action on a conference agreement in the fall.

A survey released this week by NPR, Kaiser, and Harvard should give pause to policymakers.

Yes, people do want health reform. But when they are asked how much they are willing to pay, only 6% of Americans say they are willing to spend more than $200 a month on health insurance. The price has to come down to $50 a month before a majority of Americans would be willing to pay. A mandate that all individuals must have insurance, which is still very much under consideration, would have to carry enormous subsidies to get past these objections.

Because so much of the actual cost of health insurance is hidden from workers, few of them know they are actually paying, on average, $400 a month for health insurance today. (In our view, making those costs more visible is a crucial step to their demanding more affordable coverage that is more responsive to their needs.)



Comparative Effectiveness: That same poll shows the American people do not want the government involved in making decisions about what tests and treatments will be available to them.

The majority of adults (55%) supported creation of a panel to determine which treatments are most cost efficient and effective, but many fewer people (41%) supported the idea after learning the panel members would be appointed by the federal government.

Pollster Mollyann Brodie said that people are concerned that their physicians would not have control over their health decisions. "People are really trusting of their individual doctors, and a lot of experts might say that that's, you know, misplaced trust, that the doctors don't have all the information they need," she said, adding, "But it is the individual doctors that the public most trusts to make these decisions."

Go figure. People actually trust their doctors more than the government with their health care decisions!

Patient Advocates: The issue of comparative effectiveness studies was a key topic of discussion this week at a conference of patient advocacy group leaders in Raleigh, North Carolina. These leaders are especially concerned about the government's new authority — and $1.1 billion in funding — to conduct these studies, with many fearing it will make it even more difficult for patients with chronic illnesses to get the medicines and care they need.

I spoke to the group about the health reform landscape in Washington. And while I was there, I had the privilege of meeting Amye Leong, a leading patient advocate, who was emcee of the Patient Advocacy Leaders Summit.

Amye was diagnosed when she was 18 with rheumatoid arthritis and was confined to a wheelchair by her mid-20s.

She took charge of her own care and found physicians who would work with her on a treatment plan to help her walk again. After 16 surgeries for joint replacements and spending nearly 300 days in the hospital over many years, she not only is walking unassisted but she travels the world as a patient advocate, motivational speaker, and much more. She founded Healthy Motivation in Santa Barbara, CA.

She was unbelievably inspiring and added that no one knows better than those with chronic illness the importance of the right treatment for the right patient at the right time, as well as the crucial value of continued innovation in medicine — both of which would be threatened by government dictates over care.



Politico carried an article on Monday about Republicans in Congress being in disarray over health reform.

There is some competition going on now among three different House Republican health care caucuses to develop principles and plans, but this competition is a good thing. When their plans are offered, they likely will be based upon similar policies and ideas that will put doctors and patients, not government and bureaucracy, at the center of our health system.

And their proposals are not likely to consume a thousand or more pages of legislation. We do not need a complete overhaul of the one-sixth of our economy represented by the health sector. Lord only knows Washington is not smart enough to get that right. We need to support what works and change what doesn't.

We at the Galen Institute have long advocated providing new subsidies to people who need help in obtaining coverage, providing new options for them to purchase private coverage, and building a stronger safety net to help those who have difficulty buying coverage.



The Health Policy Consensus Group will be releasing a new statement soon reinforcing our principles and guidelines for health policies that put patients first.

Grace-Marie Turner

Recent News Articles and Studies

A Trojan Horse for Government-Run Health Care
Health-Care Dialogue Alarms Obama's Allies
Uncle Sam, M.D.: AEI Scholars on Health Care and Pharmaceutical Reform
"GPS" for Health Care
Health Care Spending Forecasts


A Trojan Horse for Government-Run Health Care
Governor Michael O. Leavitt and Jeffrey H. Anderson
AmericaSpeakOn.org, 04/23/09

President Obama's public plan option for health insurance is presented as a means to promote competition and choice but would prove fatal to both, write Gov. Leavitt, former Secretary of Health and Human Services and Anderson, who was a professor of political science at the U.S. Air Force Ac
ademy. Under a widespread public option with Medicare-like reimbursement rates, the Lewin Group estimates that 118 million Americans would lose their private health insurance. If you add them to the 80 million Americans already insured by Medicare or Medicaid, no private insurance system would be able to survive. Inevitably, government-run systems cut costs by cutting access to services, many of the best doctors simply refuse to take government insurance, and a two-tiered system emerges: The rich pay for the care they want out of their own pockets, and everyone else just waits in line.

Health-Care Dialogue Alarms Obama's Allies
Ceci Connolly
The Washington Post, 04/21/09

Disputes over whether to create a new government-sponsored health insurance program to compete with private companies shine a light on the intraparty fissures that may prove more problematic than any partisan brawl, writes Connolly. The early skirmishing is perhaps the clearest indication yet of the uphill battle President Obama faces in delivering on his promise to make affordable, high-quality care available to every American. More than 70 House Democrats recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan. Last week, two top administration officials suggested that Obama is open to compromise on the public plan, comments that set off alarm bells in some corners of his party. Many Republicans and industry executives say that any program modeled after Medicare — with its power to set prices — would have an unfair advantage over private-sector companies and eventually force some companies out of business.

Uncle Sam, M.D.: AEI Scholars on Health Care and Pharmaceutical Reform
American Enterprise Institute, 04/17/09

This collection of essays brings together up-to-date research on health and pharmaceutical policy coupled with analysis by AEI health policy scholars, including Joe Antos, Bob Helms, Tom Miller, Jack Calfee, Scott Gottlieb, and Roger Bate. The first chapter focuses on what real health care reform should look like while subsequent chapters discuss health coverage of the uninsured, modernization of Medicare and Medicaid, pharmaceutical innovation, and FDA reform.

"GPS" for Health Care
Gualberto Ruaño, Genomas, and Paul Howard, Manhattan Institute
City Journal, 04/15/09

Health care's central conundrum is individual variation: we develop drugs and medical devices based on the aggregate responses of large test populations, largely ignoring the important genetic variation from patient to patient because we lack the tools to address it, write Ruaño and Howard. Hence the need for a "genetic prescription system" — an approach that uses gene-based diagnostics to help people find better and safer treatments, resulting in improved health and more efficient spending without recourse to flawed one-size-fits-all government guidelines. This is clearly the wave of our health care future, but comparative effectiveness research could slow its development. Curtailing new drugs or technologies solely because of cost considerations would deter innovation at a time when we desperately need new treatments for debilitating diseases like Alzheimer's. Further, CER tends to lag behind the scientific developments that make genetic prescribing so promising. Prospective investors in gene-based health care need assurances that Washington won't punish innovation and that there's a clear pathway for FDA approval of these products and technologies, conclude Ruaño and Howard.


Health Care Spending Forecasts
Andrew J. Rettenmaier
National Center for Policy Analysis, 04/23/09

Congress and President Obama appear intent on pursuing two conflicting goals for public and private health care: reining in costs while also increasing spending in order to expand insurance coverage to more people. But health care spending is a growing share of the economy, and forecasts by government agencies suggest it will continue to grow well into the future, writes Rettenmaier. During the past four decades, the share of gross domestic product spent on health care has more than tripled from 5% to 16%, and the CBO's projections show that health care spending may grow to as much as 50% of GDP by 2082. Given that 45% of health care spending is currently funded by government payers, future budget implications are staggering. If health care spending and personal consumption continue to grow as they have in the past, investment will decline, and economic growth will slow and maybe even grind to a halt. We can instead move to a more rational system in which people make their own choices in a system based on market-driven incentives.

Upcoming Events

Grace-Marie Turner speaking on the Small Business Advocate show
Nationally Syndicated Radio Broadcast
Monday, April 27, 2009, 7:30 a.m. EDT

Grace-Marie Turner speaking on Richmond AM show
WHON-AM Radio Broadcast
Monday, April 27, 2009, 8:10 a.m.
Richmond, VA

Legal Solutions in Health Reform Spring Symposium
O'Neill Institute for National and Global Health Law Event
Monday, April 27, 2009, 9:00 a.m. – 1:00 p.m.
Washington, DC

The Path Forward for Academic Medical Centers: Innovation, Economics and Better Health
The Brookings Institution Event
Monday, April 27, 2009, 10:30 a.m. – 12:30 p.m.
Washington, DC

Public Plan Option: Fair Competition or a Recipe for Crowd-Out?
Alliance for Health Reform Briefing
Monday, April 27, 2009, 12:15 p.m. – 2:15 p.m.
Washington, DC

Private Health Plans in Medicare: What is the Record?
The Heritage Foundation Event
Tuesday, April 28, 2009, 12:00 p.m.
Washington, DC

The SAFE Solution to Entitlement Reform
American Enterprise Institute Event
Wednesday, April 29, 2009, 9:30 a.m. – 12:00 p.m.
Washington, DC

National Medicare Education Program Coordinating Committee Meeting
Centers for Medicare & Medicaid Services Event
Thursday, April 30, 2009, 8:30 a.m. – 12:30 p.m.
Washington, DC

Grace-Marie Turner speaking on Let's Just Talk with Kathryn Raaker
Nationally Syndicated Radio Broadcast
Saturday, May 2, 2009, 10:00 a.m. EDT



Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features a commentary by Grace-Marie Turner on the major developments and issues of the week as well as summaries of writings by participants in the Health Policy Consensus Group and other articles of interest from the health policy world, plus announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org.

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