Health Reform Experts Team Up To Praise Workplace Wellness Programs

John DuBois, University of New Mexico/Talk Radio News Service

The Alliance for Health Reform joined forces Monday with the AARP and manufacturer Johnson & Johnson to promote workplace wellness programs.

The wellness programs are aimed at encouraging employees to live healthier lives, which should lower premiums and overall costs.

AARP supports workplace wellness with “Policies and services at the worksite to adress: Tobacco use, nutrition in cafeterias and vending machines, minimizing stress and promoting positive mental health and encouragement, physical activity before, during and after work hours,” said Vice President of Social Impact for AARP Nancy LeaMond.

Johnson & Johnson’s programs include online risk assessment, lifestyle and disease management counseling, mental health and well-being and health education awareness. Johnson & Johnson also doesn’t allow smoking on premises world-wide.

‘‘Johnson & Johnson’s credo is to have the world’s healthiest workforce,” said Vice President of health policy at Johnson & Johnson Kathy Buto.

“Firms want a healthier and more productive work force and they want lower health insurance costs and they think these programs can accomplish both of these goals,” said Board Member of the Alliance for Health Reform Ed Howard Howard.

Alliance For Health Reform Concerned About House Bill's Effect On Children's Health Insurance

By Travis Martinez - University of New Mexico/Talk Radio News Service

In a panel discussion hosted by The Alliance For Health Reform, area analysts on Friday discussed the recently passed House health care reform bill and its potential impact on the Children's Health Insurance Program (CHIP).

Senior Researcher with the Urban Institute Stan Dorn argued that cutting CHIP entirely would force poverty stricken families to seek alternate insurance options through work-based insurers, which may not guarantee coverage.

“Why would somebody who loves children want to end the CHIP program, because it’s less certain subsidies would be guaranteed for Medicaid in both House and Senate bills... it will bring less complexity and higher paying rates for providers,” said Dorn. “But keeping CHIP around would actually save money by CBO standards...with states knowing the program will stay around through 2019, they will become more likely to invest.”

The panel lauded the successes of CHIP, a program which Congress earlier this year extended until 2013, alloting $32 billion to be used for the renewal.

Jocelyn Guyer with Georgetown University's Health Policy Institute praised CHIP and Medicaid as two affordable outlets for families that reduce childrens' health care costs.

“We really are making extraordinary progress on children and there certainly is more to be done. Increasingly the conversation also is turning to how do we make sure coverage is translated to access, but there certainly is a strong base at which to build,” said Guyer.

Low-hanging fruit.

Coffee Brown, University of New Mexico, Talk Radio News

The Alliance for Health Reform presented findings of recent pilot studies showing that major improvements in healthcare are possible now, even in advance of new technologies and structures.

Ed Howard, Alliance for Health Reform, said that less than two percent of hospitals have “fully integrated” Health Information Technology (HIT). Even as hospitals invest in hardware, software, and training, the systems won’t work unless everyone uses them, he said. Where HIT is used effectively, he finished, quality and cost control are measurably improved. In other words, HIT does deliver better, faster, less expensive care.

But only when its use is coordinated among providers (often called “Care Teams”), according to Carolyn M. Clancy, MD, Director of the Agency for Healthcare Research and Quality (AHRQ). When the Electronic Medical Record (EMR) merely recreates the chart as an electronic document, “it can actually allow us to make the same mistakes faster.”

She cited the Provnost Study showing that when computers helped to coordinate care among all of the caregivers, using checklists, prompts, and feedback, infected lines in the ICU were reduced nearly to zero.

Jon Rasmussen, Pharm. D., Chief of Clinical Pharmacy Cardiovascular Services, and Susan Kuca, RN, Cardiac Care Coordinator, described Kaiser Permanente’s intricately coordinated care. They said the program had reduced the risk of subsequent fatal heart attack by 88 percent if begun immediately after hospitalization, and by 73 percent even if started much later, such as when a patient with existing heart disease came into the system from elsewhere.

Greg Halvorson, Chairman and CEO of Kaiser Permanente Health Plan, said we are the only industrialized country without universal health care. He said healthcare can and should be both better and more affordable. Halvorson described a RAND study covering 5 million patients over 2 years that found 25 percent of care was wrong or harmful, implying that U.S. savings in healthcare from efficiency alone could be one-half to one trillion dollars.

Diabetics account for 30 percent of Medicaid dollars, yet their carewas rated as “right only eight percent of the time.”

Big deductibles had the opposite of their intended effect by causing beneficiaries to delay care too long, he said.

In the case of chronic care, one percent of patients use 35 percent ofthe dollars, and ten percent use 80 percent of total dollars. “Chronic
care is a team sport,” Halvorson said.

The consensus of the panel was that, even without a single new treatment or device, coordination of ongoing care could save billions
or trillions of dollars, while improving outcomes.

U.S. health care could learn a few things from foreign health care systems

Thomas Bjorn Zeltner, Director-General of the Swiss Federal Office of Public Health, said an important step for U.S. health care reform was to develop "a long term vision, you need a long term consensus on where to go." He added that a long term consensus is something "I don't think you have right now." He said it was important to "plan for 20 years ahead."

At a briefing held by the Alliance of Health Reform, Zeltner also felt that it was important to "reduce the number of uninsured" as well as the "underinsured." He felt that drastic reform can be difficult on a national level, but individual state reforms can be "easier."

While the briefing highlighted the health care systems from Germany, Switzerland, and the Netherlands, Senior Fellow at the National Opinion Research Center at the University of Chicago Michael O'Grady said that health care is "not really a foreign policy competition." According to O'Grady, the U.S. should look at the successes and failures of other health care systems, but "some is transferrable, some is not."

Mark McClellan, Director of the Engelberger Center for Health Care Reform at the Brookings Institution, said that there is "a common growing interest in addressing the quality of care." He felt one sticking point in the minds of citizens was that of "provider payment." He stated that many people in the U.S. want payment based on "value" rather than "fee for service."

Diana Monissen, Director General for Curative Care of the Dutch Ministry of Health, said that the Netherlands had drastic health care reform in 2006. She said that currently in the Netherlands, basic health coverage is required by law. She also stated that risk adjustment for high risk patients. She said that their new universal health care has created "a healthier society." She felt that "sometimes you really need a big step" on health care reform.

Robert Leu, Head of the Department of Economics at the University of Bern, Switzerland, stated that the Swiss health care system is "highly decentralized" and requires "hardly any financing from federal levels." He claimed that all people in Switzerland have "equal access to care" and insurance companies "have to accept anyone."

Reinhard Busse, Professor and Department Head for Health Care Management at the Berlin University of Technology, Germany, {added to the discussion by looking at the aspect of people paying a fixed percentage of their wage towards the social health care system. He added that 85 percent of people in Germany have social health insurance as opposed to only 10 percent who have private health insurance. He added that the social system provides "access to all borrowers." He also said that individual hospitals have to report on their quality of care, so people can "compare hospitals."

The briefing was concluded by Robin Osborn, Vice President and Director of the Commonwealth Fund's International Program in Health Policy and Practice, who said that their survey showed that one third of Americans felt the U.S. health care system "should be completely rebuilt."

What's being done about health care reform

The Alliance for Health Reform held a hearing to discuss innovations in health care reform such as developments with nurse and patient relationships and transitional care.

Transitional care is a range of time limited services and environments designed to ensure heath care continuity and avoid preventable poor outcomes among at risk populations as they move from different levels of care, said Mary Naylor, director of NewCourtland Center for Transitions and Health.

Reed Tuckson, Chief Medical Affairs for United Health Group, said it is time to maximize health care assets and expand access to comprehensive programs to underinsured and uninsured. Tuckson also stressed that it is important to consult nurses about healthcare reform because they are often ignored. The media never quotes nurses, only learned professionals, Tuckson said.

The average nurse lifts 1.8 tons on an 8 hour shift, said Audrey Nelson of the Veterans Health Association. Rick Kellerman, board chair of the American Academy of Family Physicians (AAFP) said to stop blaming Congress and insurance companies on healthcare problems and start looking at what the Alliance for Health Reform members can do.