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Entries in University of New Mexico (46)

Tuesday
Feb032009

The High Cost of Doing Nothing

Coffee Brown, MD, University of New Mexico, for Talk Radio News Service

For each increase of one percent in the unemployment rate, the number of medically uninsured goes up by approximately 1 million, according to Professor Jeanne Lambrew, Deputy Director of the new White House Office of Health Care Reform. Unemployment and medical debt in turn, increases foreclosures, she stated while addressing the National Health Policy Conference in Washington D.C., speaking at the National Health Policy Conference.
The coming spike in the uninsured will trigger a provision in the recovery act to subsidize 65 percent of cobra payments. When workers lose their jobs, they usually lose their insurance as well. By law, they can continue their former plan for six months by paying the entire premium plus two percent. This is about 80 percent of typical unemployment benefits, rendering it unaffordable for most. It may be wise to offer medicare as a less expensive, longer-lasting alternative, Lambrew said.
She also expressed concern over medical error rates that are higher in America than in peer nations. Health reform is needed to address these problems and the healthcare workforce shortage as well. This in turn will create lasting jobs, and cash flow within communities, she concluded.


Robert Berensen said that there is no longer any significant debate about the need for healthcare reform, now it’s about the form of the healthcare delivery system itself. The effort to reform the system has been gridlocked for 30 years, he said.
Paul Wallace, M.D., spoke for Kaiser Permanente and Glenn Steele, M.D., spoke for the Geisinger Health System. They described private sector innovations aimed at increasing efficiency, such as varying pay structures to improve healthcare benchmarks. The most important of these was getting caregivers to adopt electronic records. This measure speeds flow, reduces redundancy and reduces errors by making sure that the patient’s history is up-to-date at each visit, even when they cannot see their usual provider.
Both physicians emphasized the importance of a patient “care home”, a clinic and staff who know the patient well. This practice, the modern equivalent of the family doctor, is increasingly common as states experiment with ways to reduce costs and increase patient satisfaction. Results reported at several recent conferences have been very positive.

Sen. Max Baucus, D-Mont., at the National Health Policy Conference, said there are several good reasons for healthcare reform right now.
First, he said, the cost of doing nothing has become greater than the cost of doing something. Prices were rising faster than inflation even before the crash, he said. By 2014, half of U.S. households will be spending 45 percent of their total incomes on health insurance premiums.
Second, the current system is failing. Costs are higher and quality markers are lower than for other industrialized nations. Medical errors are killing tens of thousands of us a year, largely due to poor Health IT systems, which are now a major item in the recovery package.
Third, there is an unprecedented degree of bipartisan and even industry support.
Baucus concluded with the statement that the first priority has to be changes that create economic stimulus, and the second needs to be speed, while the momentum is favorable. The problem, he said, is that we also have an economic crisis, two wars, and an oil-dependence crisis competing for the attention of congress and the president.
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