Would the health reform prescriptions being offered by President Obama and congressional leaders help patients?
It seems a fitting question to ask since Mr. Obama has assured Americans they will be able to keep their doctor and their current coverage if they are satisfied and will have even more choices.
Our Health Policy Consensus Group took that as a challenge to ask whether the policy prescriptions fit the rhetoric by analyzing the major reform pillars Washington leaders are proposing.
We issued a statement this week, signed by 25 health policy experts from the major market-oriented think tanks, saying, we are "gravely concerned" that their proposals "would make matters worse, not better…and would not fulfill the goals and promises made to the American people."
Then we at the Galen Institute put together a petition at DoNoHarmPetition.org that is based on the Consensus Group statement. This gives you a chance to join us in letting policymakers know they should not go in the direction of much more centralized, government control over our health sector. Please go to our dedicated website and tell us if you agree.
Here is the Consensus Group's point-by-point list of our objections to the Obama/congressional proposals:
- A new government health insurance plan that would cause up to 119 million people to lose the private health insurance they have today and "ultimately ration care and services, driving out innovation, competition, and patient-centered quality."
- An employer "play-or-pay" mandate that is basically a new tax on jobs and will cause more lost jobs and lower wages for workers.
- A uniform, government-defined package of benefits that will leave us with a "choice" of only the expensive one-size-fits-all plan mandated by government.
- A mandate that individuals must purchase insurance, leading to government dictates of what insurance must cover, what we must pay, and what fines and penalties we will face if we don't comply.
- A National Health Insurance Exchange that "would steamroll over private choice and patient preferences by providing a vehicle to extend sweeping federal regulation into virtually every corner of our health sector."
- Federal interference in the practice of medicine through a federal health board, comparative effectiveness review, and other government intrusions into medical decision-making that creates "an irresistible temptation for politicians to go beyond providing information and start restricting the treatment choices available to patients."
Our next Consensus Group statement will explain our vision of how a better functioning, more competitive, and transparent marketplace would cover more people and deliver the higher-value care we all are seeking. We believe any health reform proposal to change what needs fixing also must preserve the freedom, innovation, and quality of American medical care that people value.
Please do join us in signing our Do No Harm petition. You are welcome to put a link to it on your website, and please send the petition to as many people as you can.
The proposals we list above would put us on a super-highway toward a single-payer health care system, which Mr. Obama said during the campaign really is his first choice in health reform.
Government health insurance already is in place for children, the poor, the elderly, veterans, and others. The next step to locking in a single-payer government-run system (which fewer than 10% of Americans say they favor) is to put all working Americans and their families on a government health program.
Join us in signing our petition so your voice can be heard to First, Do No Harm and put patients first.
I am off to Guatemala tomorrow for a talk at the annual meeting of the Association of Private Enterprise Education, in a session chaired by former Medicare trustee par excellence Prof. Tom Saving. And while I'm there, I am going to visit a medical tourism site. I will report back to you after Easter. Have a blessed week.
Grace-Marie Turner
Recent News Articles and Studies
'Consensus' on Health Reform? Hardly, but a Few Good Ideas
Health Policy in the New Administration
Democrats Agree on a Health Plan; Now Comes the Hard Part
The GOP's Alternative Budget
President Obama Sells Biotech Short
Austin ER's Got 2,678 Visits From 9 People Over 6 Years
Doctors Are Opting Out of Medicare
GALEN IN THE NEWS
'Consensus' on Health Reform? Hardly, but a Few Good Ideas
Grace-Marie Turner and Amy Menefee, Galen Institute
National Review Online: The Corner, 03/30/09
A coalition of 18 groups, ranging from the AARP to the U.S. Chamber of Commerce, released a statement this week based upon six months of work to develop a bi-partisan agreement on health reform. News reports focused on the troubles the group had in agreeing to support key pillars of the reform proposals being proposed in Congress and by the White House. But Turner and Menefee report that the group came to some surprising agreements that received little attention, including: providing advanceable, refundable tax credits or other subsidies for health insurance; giving individuals eligible for Medicaid and [S]CHIP the option of using those dollars to buy employer-sponsored insurance; conducting comparative clinical effectiveness research studies; and considering the potential effects of new payment methodologies on medical innovation. The report also acknowledged that "Americans enjoy the best clinical outcomes in the world, and life expectancy is rising." It's refreshing to hear that they don't think we should give up on the American health care system, as so many others in Congress appear ready to do, write Turner and Menefee.
HEALTH CARE REFORM
Health Policy in the New Administration
Joseph Antos, American Enterprise Institute
American Health & Drug Benefits, February/March 2009
Is the $227 billion already spent b
y the Obama administration and the largely Democratic Congress merely a harbinger of bigger, more expensive health care reforms to come? Health reformers — at least those whose idea of reform consists of massive increases in government health programs — should not get their hopes up, writes Antos. Proposals to achieve universal coverage are expensive — likely to exceed $250 billion annually before savings offsets are identified — and complex, the key ingredients in political stalemate. Further, it is uncertain that the hype surrounding newly funded health information technology and comparative effectiveness research programs, touted as "pain-free" reforms, will truly result in more efficient, less expensive medical care. Rather, meaningful change must come in small increments and deal with the complexities of provider reimbursement and cost-containment in Medicare and Medicaid.
Democrats Agree on a Health Plan; Now Comes the Hard Part
Robert Pear
The New York Times, 03/31/09
Efforts to overhaul the health care system have moved ahead rapidly, with the insurance industry making several major concessions and the chairmen of five Congressional committees reaching a consensus on the main ingredients of legislation, writes Pear. The chairmen, all Democrats, agree that everyone must carry insurance and that employers should be required to help pay for it. They also agree that government should offer a public health insurance plan as an alternative to private insurance. But they have yet to tackle the question of how to pay for coverage of the uninsured, and they have not wrestled with vehement Republican objections to the idea of a new government-run insurance plan. The White House and Congress are operating on two optimistic assumptions, writes Pear. One is that if everyone had health insurance, it would be easier to control health costs. The other premise is that the nation could sharply reduce the growth of health care spending if doctors made less use of aggressive treatments that raise costs but do not result in better outcomes. But no combination of tax increases and Medicare savings comes near to covering the full cost of the proposals, which Democrats say could easily top $1 trillion over 10 years.
The GOP's Alternative Budget
Rep. Paul D. Ryan
The Wall Street Journal, 04/01/09
Rep. Paul Ryan provides an outline of the budget plan offered this week by House Republicans to offer the American people a different way forward — one based on the belief that America is an exceptional nation, and we want to keep it that way, writes Rep. Ryan. The plan works to accomplish four main goals: 1) fulfill the mission of health and retirement security; 2) control our nation's debts; 3) put the economy on a path of growth and leadership in the global economy; and 4) preserve the American legacy of leaving the next generation better off. Specifically, the budget moves toward making quality health care affordable and accessible to all Americans by strengthening the relationship between patients and their doctors, not the dictates of government bureaucrats. For those entering Medicare in the next 10 years, the program would stay the same, but after that, those entering Medicare would see a newly reformed plan intended to work like the health plan members of Congress and federal employees now enjoy. The budget plan also strengthens the Medicaid safety net by converting the federal share of Medicaid payments into an allotment tailored for each state's low-income population.
PRESCRIPTION DRUGS
President Obama Sells Biotech Short
Robert M. Goldberg, Center for Medicine in the Public Interest
Orange County Register, 03/31/09
President Obama's policies are threatening biotechnology — one of the most vibrant and important forms of small business our nation has ever produced, writes Goldberg. Obama supports de facto price controls that would allow the "reimportaion" of prescription drugs and is establishing a comparative effectiveness council to slow down the introduction of new medical technologies. The president has increased federal funding for basic research and stem-cell science. But translating discoveries into treatments will require more than the $60 billion currently being invested by pharmaceutical, biotech and venture capital firms on cutting-edge treatments for cancer, Alzheimer's, AIDS, mental illness and heart disease. Half of all public biotech firms have six months of cash left for research. For startups, the situation is direr, even though the scientific promise of their investment is great. For all his rhetoric, thanks to his policies the medical discoveries the president supports will never be translated into economic prosperity or treatments that transform humanity, writes Goldberg.
STATE ISSUES
Austin ER's Got 2,678 Visits From 9 People Over 6 Years
Mary Ann Roser
Austin American-Statesman, 04/01/09
In the past six years, nine people racked up 2,678 emergency room visits in Central Texas, costing hospitals, taxpayers and others $3 million, according to a report from Integrated Care Collaboration (ICC), a nonprofit made up of hospitals and other providers that care for the uninsured and low-income Central Texans. One of the nine spent more than a third of last year in the ER: 145 days, reports the Austin American-Statesman. That same patient totaled 554 ER visits from 2003 to 2008. ICC Executive Director Ann Kitchen said all nine patients speak English; three are homeless; five are women whose average age is 40; and four are men whose average age is 50. Kitchen estimated that each ER visit averaged about $1,000. The ICC found that 900 frequent users — people who visited an ER six or more times in three months — had 2,123 preventable visits in 2007, or 18% of 11,600 total visits to Central Texas ERs, which cost more than $2 million. Among those picking up the bill were hospitals and taxpayers, including [taxpayer-supported] government programs such as Medicare and Medicaid.
MEDICARE
Doctors Are Opting Out of Medicare
Julie Connelly
The New York Times, 04/01/09
Many people discover that the insurance rug has been pulled out from under them, just as they become eligible for Medicare, reports The New York Times. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors' reasons: reimbursement rates are too low and paperwork too much of a hassle. One option for those looking for a physician is concierge or "boutique" care, which comes in two forms. In the most popular kind, doctors accept Medicare and other insurance, but charge patients an annual retainer of $1,600 to $1,800 to get in the door and receive services not covered by Medicare, like annual physicals. Most are required to have major medical policies to cover ex
penses that are not covered by the concierge care.
Upcoming Events
The Association of Private Enterprise Education 34th Annual Conference
April 5 – 7, 2009
Guatemala City, Guatemala
Grace-Marie Turner will participate in a panel on "What Should the New Administration Do About Health Care?"
California Regional Conference on Health Care Reform
Mayo Clinic Health Policy Center Event
Saturday, April 4, 2009
Berkeley, CA
White House Regional Forum on Health Reform
Monday, April 6, 2009, 10:30 a.m.
Los Angeles, CA
The Debate: Universal Health Care Should Be the Responsibility of the Federal Government
Benjamin Rush Society Event
Tuesday, April 7, 2009, 5:00 p.m. – 7:00 p.m.
New York, NY
Innovations in Preventing and Managing Chronic Conditions: What's Working in the Real World
Center for Studying Health System Change Event
Wednesday, April 8, 2009, 9:00 a.m. – 12:00 p.m.
Washington, DC
Health Care University: Which Reforms Are Better — or Worse — than Doing Nothing?
Cato Institute Event
April 14 – 17, 2009
Washington, DC
Health Reform as a Matter of Social Justice
George Washington University School of Public Health and Health Services Event
Tuesday, April 14, 2009, 12:00 p.m. – 1:00 p.m.
Washington, DC
Health eGaming, Healthy Patients: Supporting Stimulus Goals Through Health eGaming
Disruptive Women in Health Care Event
Wednesday, April 15, 2009, 12:00 p.m. – 1:30 p.m.
Washington, DC
Grace-Marie Turner speaking on Health Talk show
WYSL-AM Radio Broadcast
Wednesday, April 15, 2009, 6:30 p.m. – 7:30 p.m.
Rochester, NY