Healthcare crisis looming

In a conference call hosted by Ron Pollack of Families USA, Mayor Gavin Newsom of San Francisco said that all major cities share the same problem and that is that they are asked to do more with less each year. He said that last year San Francisco invested over 1.5 billion dollars into the health system and this year that investment rose 20%. He said that it is projected to continue to rise at that rate for at least next year.

Newsom said that San Francisco was on the forefront of insuring those under 25. He said that his city was one one of the first to provide care for the uninsured under the age of 18 and to provide care for the uninsured between the ages 18 and 24. He criticized both the congress and the administration and said that they should both be doing more about this issue.

Pollack said that there are 47 million people uninsured nationwide. He also said that Families USA has done the most comprehensive study to date, surveying 13 major cities across the country.

The nation's ongoing struggle

The Senate Budget Chairman Kent Conrad (D-N.D.) and Senator Michael Crapo (R-Idaho) led a discussion on “Approaches to ‘Bending the Growth Curve’ on Healthcare Spending.” Both Senators agreed that healthcare is the single largest threat to long term fiscal outlook and that the most affective way to end the “nation’s ongoing struggle” is to gain bipartisan support.

Peter Orszag, of the Congressional Budget Office, said that the United States’ political system does not deal well with gradual, long term problems, which is what the healthcare issue has turned into. He explained that the nation needs much more information on what works and what doesn’t when it comes to healthcare, needs more financial incentive to make a change, and needs a behavior change into a healthier lifestyle.

Elliot Fisher, of the Dartmouth Institute for Health Policy and Clinical Practice, said that the United States needs to focus on supply sensitive services. He explained that the current system rewards growth and spending, a policy that needs to be changed. Fisher also said that there are three main healthcare areas that need attention: payment, capacity, and clinical judgment.

Scott Serota, of the Blue Cross and Blue Shield Association, said that there is generally uniformity and agreement on the healthcare issues, and asked “why aren’t we doing it?” Serota had four recommendations on the areas that he thought needed focus. He said that research on “what really works” needs to be encouraged, there needs to be a change in incentives, consumer and providers needs to be empowered to make good decisions, and a focus on health and wellness needs to be promoted.

Healthcare challenges daunting for United States’ economy

Ben Bernake, the Chairman of the United States’ Federal Reserve, gave his remarks on improving the performance of the healthcare system at the Senate Finance Committee’s “Prepare for Launch” Health Reform Summit. Bernake said that improving healthcare is one of the most important problems facing the United States’ economy.

Bernake explained that healthcare is both an economic and social issue; it is the fastest growing sector of the economy exceeding 15 percent of the overall national Gross Domestic Product. Bernake said that there are three areas of focus that need to be addressed: access, quality, and cost. Access of healthcare needs to be expanded because the amount of Americans without insurance is steadily increasing. Bernake also said that an uninsured individual is 30 percent more likely to die from a car accident than someone insured because they will not be treated as quickly and thoroughly as necessary.

Bernake said that the quality of healthcare also needs to be increased. Last year about 98,000 people died in hospitals because of medical errors. Bernake explained that the scope for improving patient safety remains extremely large and that there exists a disturbing gap between the principle and practice of quality healthcare.

Controlling the costs of healthcare is the last issue that Bernake spoke about. The United States’ per capita spending is greater than per capita incomes. Bernake said that the country’s spending exceeds most industrial countries and it keeps increasing. He also said that the high cost of healthcare is much higher than necessary. Bernake explained that taking on these challenges will be daunting for the United States and no single set of reforms will address all the problems. He said that an eclectic approach which meets each individual problem in a different way will be best.

Health insurance a societal obligation

Forty-five million uninsured Americans prompted the Senate Finance Committee to discuss ways to reform health care, listening to recommendations that could help to provide insurance coverage to the uninsured. According to panelists, the uninsured are shut out of the system due to increasingly high health care costs, high insurance rates, and partial coverage.

Ron Williams, the CEO of Aetna, told the committee that lowering insurance rates will require lowering the cost of health care since the price of insurance reflects on the cost of treatment. Williams also said universal participation in health insurance is necessary to lower prices and help those in need, comparing societal assistance in health care to food taxes that help feed the hungry. He noted that patients seeking coverage after being diagnosed with a serious illness is not insurance but in fact a way of financing treatment, suggesting that measures be taken to combat reactionary purchases of health insurance. Williams also said that grouping people by methods other than risk factors would allow for an even distribution of healthy and unhealthy and prevent costs from skyrocketing due to an influx of customers needing high remittances.

Mark Hall, a professor at Wake Forest University, agreed with Williams’s idea of grouping customers into pools without determining risk factors. Hall said that one percent of the American population uses almost 25 percent of federal expenditures on health care while half the population uses four percent. Hall said that pooling would allow natural statistics to have an effect on health prices by preventing concentration of the sick. Raymond Arth, a small business owner from Ohio, urged the committee to be conscious of small business owners. Arth said that small business owners desire to provide health insurance to employees but that increasing renewal figures make it difficult financially.

Focus of healthcare system questioned by experts

A panel of experts from the Alliance for Health Reform held a press conference where they discussed issues with the healthcare system and solutions that the respective presidential candidates have proposed.

Mark McClellan, director of the Brookings Institution’s Engelberg Center for Health Care Reform, explained that there is a need for an “underlying change” in the way treatment is implemented. According to McClellan, the current system should focus on more effective treatment that would address patients’ immediate needs instead of inefficient care that leads to further visits.

Presumptive Republican presidential candidate John McCain’s proposals are not new, said McClellan. One reason for this is that the Bush administration tax cuts and the Iraq War have hampered the system from adjusting spending.

Uwe Reinhardt, professor of economics and public affairs at Princeton University, stressed the importance of advanced Health Information Technology that traces the cost of treatment and the quality of the care. Such technology, however, can cost individual hospitals 50 to 60 million dollars a year to maintain