Posts Tagged ‘Health Reform’
March 25, 2010
President Obama is on the road selling health reform and showing the leadership that many Americans expected of him much earlier in his presidency. You have to sell the American people not only on the value of health care for the individual but also the benefits of caring for your neighbors, friends, communities, and the nation. Sometimes Americans forget the values and principles upon which we built this country.
At a recent International Forum in Washington, health leaders from around the world were congratulating me and other Americans because our nation finally made the grade, so to speak, with regard to health care. The U.S. finally recognized that health care is national issue–that translates into security economic growth and prosperity for the nation. Most of all, it means that our nation has finally learned that the role of government is to protect and take care of all the people who believe in justice and democracy.
Tags: American Justice, American Values, Health care, Health Reform, National Economy, president Obama
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March 11, 2010
As President Obama stumps the country trying to regain leadership on health reform—and get the health reform bill passes—he is now taking aim at the health insurers. Citing big rate increases for buyers of individual insurance policies in some states — 40 percent, 60 percent, even 100 percent — Mr. Obama is trying to focus attention on provisions in the legislation that he says will protect consumers from the worst excesses of insurers.
Is this too little too late? Where was the President’s voice early on? The process the President set in motion months ago has clearly emboldened the insurers and pharmaceutical companies. One could argue that they know now that nothing substantive will change and they have carte blanche to do whatever they want.
HHS Secretary Sebelius is also confusing the insurance issue. Today she told insurers, “It’s not too late to work on this issue together, for insurance companies to come to the table and work with us.’’ Last week, the Secretary was attacking rate hikes by insurers in California.
It’s hard for the American public to get the Administration’s message straight. The President and the Secretary have not focused on the day-to-day actions of the insurers that people can relate to and understand. The insurers have gone hog wild on restrictions on drugs and services and pre-certifications for drugs and services. People experience that every day. People are frustrated and fighting that every day—and time and energy with the insurers (I should say with a recorded message machine that the insurers hide behind). That’s the insurance industry the American people know. Who will monitor that? Where is that in health reform? Will supporting health reform get the insurers out of medical decision making? That is what the people want and that is what the President is not addressing.
Tags: Barack Obama, Health care, health insurance, Health Reform, Insurance, kathleen sebelius, President of the United States, United States, United States Secretary of Health and Human Services
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February 27, 2010
Was anything accomplished at President Obama’s health care summit on Thursday? Some policy wonks did not even turn on the TV, so interest is apparently lagging at this point. Who calls a summit in the middle of the Olympics, when any accomplishment pales in comparison to the thrill of watching snowboarders, skiers, Apolo Ohno or the South Korean skating queen?
Much time was spent on niceties and posturing on bipartisanship (mostly that health care costs money), and very little on substance (except that health care costs money). The president is still not clear on what he stands for (except that health care costs money) even though he put forth a slightly modified version of the Senate bill as his plan. Americans want to know about being cared for–not about money. The President did not have a clear message about why the Congress should pass legislation that is not a true overhaul of the system.
The President has a messaging problem; the Republicans do not. The Republicans are saying “start over.” The other simplistic Republican answer–medical malpractice reform– also came across more clearly than the President’s analysis of the costs of insurance premiums. The President spent too much time on the intricacies of lawmaking, turning the summit into a high school civics class.
The American people want the President to be stronger–to say that health care is a right and that the President will not negotiate on that issue and will only work toward legislation that covers and protects all Americans and does not put money in the pockets of health insurers. Only Senator Jay Rockefeller of West Virginia, with his analogy of insurers to sharks, brought clarity –and some emotion–to the day.
Americans don’t want to hear about the market based approach to health care, words that the President used too often. Americans know that’s what got us to the place where we are today. Such rhetoric breeds fear not favor in the hearts of most Americans. The President is having a hard time with the message because his legislation does not back up the promise of the campaign.
Some credit must be given to the summit participants who sat for 7 hours in THOSE CHAIRS–typical uncomfortable seating for weddings or bar mitzvahs when half the time is spent on the dance floor. No wonder nothing happened.
Tags: bipartisanship, health insurance, Health Reform, health summit february 2010, president Obama
Posted in Health Reform, president Obama | 3 Comments »
December 17, 2009
Two people recognize the health reform bill is not reform and are signaling that we need to start anew.
Sen. Bernie Sanders, the Independent from Vermont, is telling the world that the proposed legislation is not good. Yesterday, he said that he could not accept the health reform bill in its current form because it does not control costs or rein in health insurance companies. More important, Senator Sanders showed the courage of his convictions and brought a real answer to the Senate and the American people. He proposed a single-payer amendment to the current bill. In calling up his amendment, Sanders said, “For the first time in American history, the Senate will debate a proposal to create a single-payer, Medicare-for-all health care system.” Unfortunately, Senator Tom Coburn (R-Okla.) objected to Mr. Sanders’s request to dispense with the reading of the 767-page amendment (as called for earlier by Coburn). After nearly three hours of listening to a team of Senate clerks read the proposal, Mr. Sanders gave up and withdrew his amendment (Why, Bernie? There’s nothing to fear but fear itself.)
(Of course, Coburn knew that would be the outcome because the dealy would prevent a vote on a funding bill for the Department of Defense. The current funding provision expires at midnight tomorrow).
George Will reflects today in The Washington Post on the latest CNN poll showing that 61 percent of the public oppose what the Democratic Senate is trying to do to health care. “It is clear what the public wants Congress to do: Talke a mulligan and start over.”
Bernie and George are both saying that what we have is not good enough. President Obama should say the same and ask for the creation of a “super special” congressional committee to start anew in January. Health reform before the holidays may not make the season jolly.
Tags: George Will, Health care, health insurance, health policy, Health Reform, president Obama, Senator Bernie Sanders, Senator Tom Coburn, Single-payer health care, United States, United States Congress, United States Senate, Washington Post
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November 24, 2009
In the recently released Senate Bill on Health Reform, the establishment of a National Health Care Workforce Commission that “develops and commissions evaluations of education and training activities to determine whether the demand for health workers is being met” is proposed on page 1278. (As an aside, I am concerned with the use of the word “demand” in the sentence, as the word “need” would more accurately reflect the spirit of true health reform).
Earlier this month, House Speaker Nancy Pelosi released the House’s proposal for reform, calling, on page 1275, for the establishment of a “permanent advisory committee…[that would] develop and implement an integrated, coordinated, and strategic national health workforce policy relective of current and evolving health workforce needs.”
The Association of Academic Health Centers is pleased to see both recommendations, which in part reflect our advocacy efforts on Capitol Hill to make the health workforce a priority issue in health reform.
These Bills reflect some of the recommendations in our 2008 report Out of Order, Out of Time: The State of the Nation’s Health Workforce. The report presented a comprehensive overview of health workforce policy (or, perhaps more aptly said, the lack of health workforce policy) and concluded that health reform cannot ultimately be successful without health workforce reform. The report was widely circulated and followed up with testimony before the Senate Finance Committee, multiple meetings with offices in the White House, DHHS, and a variety of letters, news releases and so forth.
While neither the House or Senate Bill captures many of the critical recommendations in the AAHC Report, both attempt to address critical workforce issues and raise the significance of health workforce policy. At this point, the fate of these Bills and the outcome of health reform is not known. However, we are taking this opportunity before floor debate in the Senate to stress with the Congress the need for broad and comprehensive approaches to workforce policy, and the compelling need to connect the health reform with the health workforce.
Tags: Health Reform, health workforce, House health reform bill, Senate health reform bill
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November 11, 2009
The voluminous healthcare bill passed by the House of Representatives last week overlooks several of the most egregious problems in our dysfunctional system. Among them:
Lack of meaningful oversight of the hugely expansive and expensive private insurance industry bureaucracy, resulting in rate increases that do not go to patient care. The most recent memorandum from the board of the group health insurance plan associated with my workplace shows double digit increases in the rate history of the medical plans provided by this group. These are increases above inflation and cost of living and above the rate of any raises received by the average American.
Interestingly, some of the largest increases came in 2009, as health insurance reform started to move forward (from 12.4 to 28%, depending on the plan). Insurers are not stupid. They know how to make a fast killing as reform creeps forward and there is nothing to mandate that such actions do not continue into any reform era.
Tiered prescription and prescription precertification. Insurers are making medical decisions. Insurance companies are mandating increasing numbers of medications must be pre-certified. Insurance companies, not physicians, will tell you whether you are allowed to take the drug prescribed by your physician. This is happening now and nothing in the legislation will prevent more of this in the future.
Who will investigate the subversive practices that are emerging, such as demanding precertification for an ever-expanding list of procedures and then denying payment (a practice that is growing at a startling speed)?
Will Congress now make a change and ensure strong oversight of this industry? Who will monitor the rate increases? What will be the penalities? Who will enforce the law? Too many in the Congress have conflicts of interest when it comes to the industry–whether through contributions or spouses sitting on boards or lobbying for the industry.
The insurance companies have been emboldened by the ineffectiveness of Congress on health reform. Until Congress can push back and ask the hard questions of the companies that over the last decade increased rates well beyond any cost of living or national standard, we will have no real reform.
Tags: Congress, doctor-patient relations, Health Reform, House health reform bill, insurance industry, insurance rate increases, patient care, precertification
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November 2, 2009
As we have previously noted, interprofessional education and practice is somewhat of a buzz word these days. While there might be an informal consensus of opinion that the health care of the future needs to involve meaningful integration of various health professions into patient-care teams, we have pointed out how the rhetoric in this area is far in front of the reality (see Oct 22 post). We are aware of many fine institutions engaging in important interprofessional activity, but not enough has been done to focus on this issue at the national level. At a recent meeting that we convened on the topic, the following observations emerged:
- The current approach to interprofessional education is a study in grass roots development, as opposed to top-down leadership;
- Interprofessional education and practice sometimes operate at the periphery of the institution, and are not engrained in the institutional fabric;
- Attaining accurate predictions and assessments of the skill sets that will be required of health professionals in the future is vital;
- Determining whether the “education tail” wags the “practice dog” or vice versa is important in developing the content and substance of these programs;
- The drivers of interprofessional education and practice need to move beyond “belief” and be more empirically driven; and,
- Health care reform may create demand for interprofessional education and practice by pushing to better align health professional education with the evolving health care needs of the public.
Health care reform holds the potential to serve as a catalyst for disruptive innovation in health care, and, in so doing, bring interprofessional health care into the mainstream. Indeed, the drive to create value in health care may lead to team-care as a paradigm that needs to be integrated with health professions education.
Tags: Health Reform, health workforce, interprofessional education, interprofessional practice
Posted in Health Reform, Uncategorized, health professions education, health workforce | 1 Comment »
October 30, 2009
Yesterday, House Speaker Nancy Pelosi (D-Cal.) unveiled proposed health reform legislation from the House. Put together from the work of three House Committees the bill includes a public option.
Also significant, the legislation also now includes language identical to the recommendation made by the Association of Academic Health Centers (AAHC) that a permanent health workforce advisory committee develop and implement “an integrated, coordinated, strategic national health workforce policy.” The AAHC has advocated for a national workforce planning entity because it believes that the nation’s workforce policy must be changed; the nation’s customary piecemeal approach to the workforce is no longer viable or appropriate for the 21st century.
A comparable Senate bill is still being negotiated. The Senate should not only include such language in any final bill but also move to ensure the creation of a permanent planning entity that operates continuously, makes ongoing findings and recommendations, and is available at any time to provide consultative support to federal, state, and private health workforce stakeholders. The planning entity must serve as an active policymaking partner, not a passive advisor.
The AAHC has been urging the congressional committees and congressional leadership to broaden the scope of activity of the proposed advisory committee/national commission to fully support a strategic national policy approach.
Specifically, the AAHC recommends the following modifications be incorporated into any health reform legislation considered by the full House and Senate:
- Make development and implementation of an integrated, coordinated, strategic national health workforce policy the primary objective of any advisory committee or national commission.
- Constitute the advisory committee or national commission as a continuously available policy research and consultative resource, not simply as a body of external experts that convenes from time to time to make periodic recommendations.
- Amend the enumerated issues to be addressed by the advisory committee or national commission to include the harmonization of conflicting national and state-based regulatory and private self-regulatory standards (e.g., licensure, scope of practice, accreditation).
4. As an interim step, create a national health workforce coordinator to assess current federal capabilities and prepare agencies for their interactions with the advisory committee or national commission once it is fully functional.
This is the way to ensure that the nation has the health workforce it needs for the short and long-term.
Tags: association of academic health centers, Health Reform, health workforce, House health reform bill, nancy pelosi, national health workforce planning entity, national health workforce policy, Senate health reform bill
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October 29, 2009
We all know that the employment picture in the U.S. continues to be dark. One in 10 Americans who wanted a job last month were unemployed. What many do not know is that private sector employment growth fell short of the number of new people entering the labor force by more than 500,00 jobs each year throughout the 1990s! The bottom line: Economists say the U.S. job creation engine has been stalled for the better part of a decade. New enterprises are not coming on line. As older industries die, established industry and entrepreneurs are not entering the market place and using capital to create jobs.
So where will jobs come from? Health care is an obvious choice. It’s time for a public policy to support this growth industry with a Jobs Bill for Health Care (similar to the post World War II GI bill). The bill would provide funds to train all comers – from the returning war vets to the unemployed, from the dying manufacturing industries to the recent high school graduates. This will produce not only the health workforce that the U.S. so desperately needs in the near and long term but also create a “product” that can be exported overseas – trainers for other countries’ healthcare challenges.
In addition to direct investment, the government should ensure funding from the insurance industry and providers who do not now train health professionals but depend on the health workforce . Let’s ensure the health and economic future of the United States with a public-private partnership that makes sense.
Tags: GI Bill, Health Care Workforce Bill, Health Reform, health workforce, jobs, U.S. Economy
Posted in Health Reform, Policy, U.S. Economic Growth, health economics, health professions education, health workforce | No Comments »
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