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Eight Health Leaders Respond to Obama's Healthcare Summit

 |  By cclark@healthleadersmedia.com  
   February 26, 2010

As he launched his healthcare summit Wednesday, President Obama said he hoped his televised effort to garner consensus for reform "isn't political theater, where we're just playing to the cameras and criticizing each other, but instead are actually trying to solve the problem."

"Here's the bottom line. We all know this is urgent. And unfortunately over the course of the year, despite all the hearings that took place and all the negotiations that took place . . . this became a very ideological battle. It became a very partisan battle and politics I think ended up trumping practical common sense," he said.

Over seven hours of broadcast, it became clear that very deep divisions remain. And it is unclear whether any package can conquer entrenched Republican opposition. Was it political theater or real progress toward meaningful reform?

We asked health leaders to comment on what they took away from the debate. Here's what they said.


Glenn Steele, MD, PhD
President & CEO
Geisinger Health System

"The debate on healthcare reform certainly found its way to center stage at Thursday's bipartisan healthcare summit. While the players may change, the concern is palpable—America's healthcare numbers are staggering.

"The American people are spending 50% more per person than other countries. Yet, 50 million are uninsured. Health-related costs are the top cause of personal bankruptcy. In Pennsylvania, insurance premiums have doubled.

"In order to protect the quality of our health services, changes must be made. The President and the leaders attending Thursday's summit appear to agree on the need to reform healthcare—and clearly have to hammer out the process.

"Solving this crisis will not be easy. We must address how we pay for healthcare as well as how we deliver healthcare. The longer we wait, the longer the system will be required to cut reimbursements instead of incenting programs that improve quality, expand coverage, and reduce costs.

"If our leaders would set an example of collaboration around health reform, then we can hope that medical professionals will soon collaborate around re-engineering healthcare delivery. Then and only then, a healthier America will be within reach."


Lori Heim, MD
President
American Academy of Family Physicians

"Thursday's National Health Care Summit provided a useful vehicle for much-needed open discussion about the merits and challenges of healthcare reform efforts. Both Democrats and Republicans brought forth ideas that can contribute to a solution.

"The summit clearly demonstrated the intricate balance that we must strike if we are to regain control of an industry that consumes 17% of our gross national product and affects 100% of Americans.

"Healthcare reform must have three elements:

  1. "1) Everyone will have healthcare coverage, including catastrophic protection.
  2. "2) Everyone will have a patient-centered medical home.
  3. "3) Healthcare will be a shared responsibility of individuals, employers, government, and the private and public sectors. Critical factors for success include controlling costs and paying for a reformed system based on primary care, and ensuring an adequate number of family physicians.

"The summit shined a bright light on philosophical agreement and differences about the process to accomplish these goals. But I'm hopeful that our lawmakers can come to agreement and move forward.

"We agree with Rep. James Clyburn, D-SC, that we must expand access to primary medical care by expanding community health centers. We agree that healthcare reform must value and support preventive care and coordination of care—positions taken by Sen. Tom Coburn, R-OK, Sen. Charles Schumer, D-NY, and the proposed healthcare legislation.

"We have long called for tort reform and I think we heard today a willingness to examine additional ways to improve the approach our malpractice litigation. Even if we disagree on the amount of savings due to defensive medicine costs, we are more in agreement that patients don't have access to physicians or medical procedures due to prohibitive malpractice premiums."


James Rohack, MD
President
American Medical Association

"What we cannot and will not support is stalemate. Our message to those attending the summit is:

"You know full well the problems facing patients and the physicians who treat them. Focus on the provisions that improve patient access to high-quality medical care; remove barriers to care through common sense insurance reforms; reduce health system costs; and sustain the vital patient-physician relationship.

"One sure-fire way to significantly reduce health system costs is to expand and adopt medical liability reforms. Many respected budget and policy experts have long concluded that defensive medical procedures, prompted by the threat of litigation, add substantial costs for individuals, private and public payers.

"The current legal environment runs counter to efforts to improve value and appropriate utilization of healthcare services. A mix of proven medical liability reforms and new initiatives will correct this perverse legal environment, benefit patients on several levels, and ensure that injured patients are fairly and promptly compensated. It has taken far too long for the greater good to prevail over the interests of the trial bar in our nation's capital.

"Permanently repealing the long-outdated Medicare Sustainable Growth Rate formula is yet another way that Congress can address healthcare reform in a fiscally responsible way. At this moment, political brinksmanship is eroding access to care and creating needless anxiety for Medicare and TRICARE patients and their physicians.

"Finally, at the heart of any successful health system reform legislation must be continuing recognition of the need to remove barriers to patient choice.

"Physicians, not unlike the broader community of voters, have sharply divergent views about pending reform plans. Yet, the overwhelming majority of physicians know without doubt that major reforms to our nation's health system are necessary."


Blair Childs
Senior vice president
Public affairs
Premier Healthcare Alliance

"We applaud the Obama Administration and Congressional leaders for continuing discussions to advance healthcare reform legislation.

"While disagreements persist, participating lawmakers agreed there is a need to address the perverse incentives in the current system that lead to inefficiency, excessive costs and rewards for quantity rather than quality.

"Members of the Premier Healthcare Alliance remain committed to legislative reforms that more appropriately align these incentives.

"These include the budget neutral expansion of hospital value-based purchasing, a national pilot to test the effectiveness of bundled payments, and provisions allowing CMS to join existing Accountable Care Organizations. These concepts should be advanced in any form of legislation, regardless of whether Congress tackles these issues incrementally or as part of a more expansive package."


Jane Cline
President
National Association of Insurance Commissioners
West Virginia Insurance Commissioner

Sandy Praeger
Chair
NAIC Health and Managed Care Committee
Kansas Insurance Commissioner

"There has been a lot of discussion about a provision in the President's healthcare reform plan that would grant the Secretary of Health and Human Services some authority over proposed healthcare premium increases.

"The state insurance regulators, represented by the NAIC, have been working closely with the congressional drafters and the administration to make certain the legislation preserves the critical role of state regulators and continues the use of objective standards in the rate review process.

"We understand that the final language will simply establish a federal backstop to assist those regulators who currently do not have full rate review authority under state law and ensure that proposed rate increases are truly justified and receive a thorough review before they become effective, and we understand the new federal authority would not be used to overturn state determinations.

"We support this concept of a federal-state partnership, as states are in the best position to make objective, actuarially-based determinations about the appropriateness of health insurance premiums. We appreciate the willingness of Secretary Sebelius, Sen. Feinstein, and Rep. Schakowsky to work with state regulators to enhance rate review across the country.

"State insurance regulators are very pleased that the President's overall proposal emphasizes state-based reforms. The plan includes state-designed exchanges and considerable flexibility for states to implement the federal standards in a way that best meets the needs of their populations.

"We also applaud the insurance market reforms, which guarantee that individuals will be able to purchase insurance even with pre-existing conditions and ensure that individuals are not rated based on health status.

"However, we remain concerned about the inadequacy of the individual mandate, which could lead to a dysfunctional marketplace and higher rates for consumers. We are hopeful this critical issue will be addressed.

"Finally, the members of the NAIC are strongly opposed to any bill in which the federal government allows insurance carriers to sell their products in our states using the regulatory rules of another state.

"This misguided proposal would increase premiums for those who need insurance the most and eliminate important consumer protections. It would also fragment the insurance market and expose consumers to increased fraud and abuse. This concept must be rejected and the decision whether to allow, and under what conditions to allow, interstate sales of insurance should be left up to the individual states."


Anthony Wright
Executive Director
Health Access California

"The summit reinforced that the need and urgency for health reform, to provide security and stability for those with coverage, and to provide affordable choices for those lack it.

"The systemic healthcare problems in California came up repeatedly, showing the need for stronger oversight and regulation of insurers.

"We were disappointed that so many Republican leaders wanted to delay reform and start from scratch, rather than move ahead with the reforms that Californians desperately need.

"The major reform that Republicans pushed is the concept of selling health insurance across state lines. Allowing insurers across state lines would obviate all California consumer protections, allowing insurers from other states with much weaker regulations to sell substandard products.

"If an insurer or HMO is licensed in another state and a consumer needs recourse, how would the consumer complain? By calling the insurance commissioner in another state? How would the consumer even know where to call? This measure effectively eliminates all enforcement against health insurers and HMOs.

"California provides many consumer protections because of a long history of abuses by HMOs and health insurers. Other states provide few or none."


Robert Kirsch
National Campaign Manager
Healthcare for America Now

"We appreciate President Obama's attempt to reach out to Republicans one more time, but today's bipartisan summit proved the GOP is committed to little else than repeating the same stale talking points.

"We need reform to be sure that Americans are not left out or priced out of the best healthcare available. While the President and Congressional Democrats clearly understand our healthcare system is broken, Republicans at the summit showed they are grossly out of touch with the everyday struggles of working Americans when it comes to their being able to get the healthcare they need.

"It's now time for the President and Democrats to finalize a bill, and with or without their Republican colleagues, pass legislation that works for us—not the insurance companies—and gives us all good healthcare we can afford."

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