Here's At Least One Viable Plan For Health Care Reform This Year

September 24, 2009 - Star-Ledger
By Tommy Thompson and Doug Dority

The need for health reform grows more urgent by the day. Costs are skyrocketing, hurting families and businesses. The Kaiser Family Foundation reported last week that the average company-sponsored health insurance premium for a family is $13,375, an increase of 131 percent over the last decade. The Business Roundtable tells us that businesses’ health care costs will nearly triple in the next ten years if no action is taken. And the Census Department recently reported another increase in the number of Americans who don’t have health insurance – now at 46.3 million.

After months of public discussion, the bill introduced last week by Senate Finance Committee Chairman Max Baucus has ignited fresh conversation on both sides of the aisle. Fortunately, there are some consensus components in the bill that provide a lot that both parties should rally behind.

One of the reasons health care is so expensive is because as a nation we spend too much money treating diseases after they’ve advanced and not enough to prevent diseases in the first place. Today, only one percent of health spending addresses prevention, even though the World Health Organization reports that 80 percent of all heart disease, stroke and type 2 diabetes and up to 40 percent of cancer incidence can be prevented. That must change if we’re going to bring down health care costs and help people live healthier lives.

The Baucus path would move us in this direction by mandating insurance coverage for physician-provided preventative care, including screenings and prescription medications. It would also boost funding for workplace prevention and wellness programs that have improved health outcomes and reduced growth in health costs in many corporate settings.

Much of the waste and needless duplication in the U.S. health system comes from lack of coordination among doctors and hospitals. Baucus addresses this issue head on by reimbursing Medicare providers based on how successful they are at preventing and treating disease — rather than paying per test, procedure or hospital visit, which encourages overconsumption of medical care.

According to a recent survey commissioned by America’s Agenda, 75 percent of voters support reform that will increase coordination in the care of chronically ill patients that account for 95 percent of Medicare spending by giving their family doctors the support of a coordinated team of allied health professionals like nurse practitioners, nutritionists and preventive care specialists. The Senate Finance Committee should include a provision that establishes such community-based health teams to work with family doctors to provide continuing care between doctor visits and after discharge from hospitals. Community-based health teams would increase productivity of family doctors, decrease medical errors, provide support patients need so often to stay on their personal care plans, and reduce health costs over the long run.

The plan Baucus outlined last week proposes to expand access to health care in several ways. First, it would forbid insurance companies from denying coverage to people with pre-existing conditions, dropping coverage when people become ill, or suddenly imposing spending caps on people when they get sick and need coverage the most. These insurance regulations have broad support among Americans and are elements of the five major health reform bills.

Further, state insurance exchanges would give individuals and small businesses wider access to insurance plans, helping assure that people always have choice and competition when they’re shopping for health insurance. In addition, tax credits in the proposal would make it easier for small business to provide insurance to their employees.

There are legitimate concerns with elements of the bill, but they should not obscure the fact that there is substantial common ground. The Baucus bill isn’t the end of the road, but it is an important milestone. Health reform is possible this year.

If we don’t act now, health care costs will continue to devour more of our income and burden small businesses trying to expand and create jobs — while leaving tens of millions of people uninsured and vulnerable to a health emergency.

That’s unacceptable. We urge Congress to work with President Obama and leaders in both houses to hammer out a final agreement based on common sense principles. Senator Baucus and his fellow negotiators have made important progress. Now it’s time for the full Congress to finish the job.



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