The Carter Samuel Martin Children's Chair for Innovative Therapy was presented to Howard M. Katzenstein, MD, on March 3. Katzenstein is director of Clinical Research for Children's Healthcare of Atlanta and director of the Innovative Therapy program with the Aflac Cancer Center of Children's. Katzenstein also is an associate professor of Pediatrics with Emory University.
Thomas Barker, former acting general counsel at the Department of Health and Human Services, has joined law firm Foley Hoag LLP as a partner in its Healthcare and Life Sciences practices. Barker will be splitting his time between the firm's Washington, DC, and Boston offices and will focus on complex federal legal and regulatory healthcare policy matters and general rule makings.
University of Michigan President Mary Sue Coleman has named nationally recognized pediatric endocrinologist and researcher Ora Hirsch Pescovitz, MD, as the University's executive vice president for medical affairs and CEO of the U-M Health System, pending the approval of the Board of Regents at its March 19 meeting. Pescovitz is executive associate dean for research affairs at Indiana University School of Medicine, where she leads basic and clinical research initiatives. She is also president and CEO of Riley Hospital for Children and interim vice president for research administration at Indiana. In this new role, which begins May 11, Pescovitz will oversee the U-M Health System: the U-M Hospitals and Health Centers, which have more than 12,000 employees and a 2009 operating budget of more than $1 billion; the U-M Medical School, which has more than 2,600 faculty, 1,600 students and trainees and receives more than $340 million in total research funds; and the School of Nursing.
The American Federation of State, County and Municipal Employees and the Service Employees International Union have pulled out of a broad coalition seeking agreement on major changes in the healthcare system. The move illustrates the difficulty of reaching agreement on two of the knottiest issues in the healthcare debate: whether to offer a new government-sponsored insurance option and whether to require employers to help pay for employee health benefits.
Sacrifice is emerging as a recurring theme in President Obama's call for healthcare reform. At a half-day healthcare summit at the White House on Thursday, the president told a room full of key stakeholders on the issue that there should be no "sacred cows" in the discussion on healthcare reform, which he said will require sacrifices from everyone.
"Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect. If that is the measure we will never get anything done," Obama told about 150 people from the across the healthcare spectrum who were invited to the meeting. "But when it comes to addressing our healthcare challenge, we can no longer let the perfect be the enemy of the essential."
Bill Roper, MD, the CEO of UNC Health Care and the former director of CMS and CDC, says the public will most assuredly have to make adjustments in their own healthcare services to make the reforms work.
"Sacrifice is inherent in remaking the system," Roper says. "It's right to start talking about sacrifice because that is what is going to have to happen if we are going to have better quality and more cost-effective care. We've got to implement better information and better protocols and guidelines for the management of patients."
"We spend more per capita than any other nation in the world, so I would stipulate that we have plenty of money in the system. So, to cover those other approaching 50 million uninsured people means taking something that is currently being spent on you and me and spending it on a person without health insurance. That by any other name is a sacrifice."
Americans weren't willing to make that sacrifice in 1993, when President Bill Clinton tried unsuccessfully to push through sweeping healthcare reforms. "The Clinton reform effort ran aground when the average American realized that what was really being discussed was restricting their ability to do something and thereby save money from their care and use that freed up money to fund the care of somebody else," Roper says.
Roper says he has long been "deeply committed" to evidence-based medicine and he supports the $1.5 billion in Obama's stimulus plan that is earmarked for the process. "But what that means is we will come up with better information on what works in what setting and that means we will say 'no' to your request for knee surgery or x, y, or z procedure," Roper says. "That means a sacrifice. The American people are owed our honesty in this debate and I'm delighted that we are beginning to do that. To go around saying, 'We have the world's best healthcare system,' which we don't, and saying, 'You can keep every bit of healthcare you got if you want to keep it,' are just not going do it."
Helen Darling, president of the National Business Group on Health, told The News Hour with Jim Lehrer on Thursday that determining coverage levels and the affordability of any universal health plan would be problematic. "Someone will have to decide whether or not the package of coverage that is going to be offered and paid for is going to be very rich, or adequate and good but not totally comprehensive," she says. "The hardest decision for the people who want universal coverage is to say, 'We may not be able to immediately afford everything for everybody the first year out.' The packages right now in this country, unless somebody is going to give up some income, cost a family about $15,000. Coming up with that for families, and to finance that, particularly all the ones who will need subsidies, especially now, is going to be very hard."
Let Congress Write it. Roper supports Obama's decision to let Congress write the bill. "The president and his team are wise to say they are going to articulate a set of principles and leave it to Congress to shape specific legislation. That is a far more promising way of going about it than the Clinton administration did 15 years ago," Roper says.
Brandon Edwards, president/COO of Davies Public Affairs, which focuses on three industries including healthcare, says Tom Daschle's withdrawal as the nominee at Health and Human Services has left many observers with a sense of uncertainty. The general belief was that Obama supported Daschle's plan. In the case of current, Kansas Gov. Kathleen Sebelius, there are questions about what she supports.
As a result, Edwards says, Sens. Max Baucus and Ted Kennedy are rushing to get their own reform proposal through Capitol Hill. "I think most people, including me, assume that this is a horserace between Baucus' plan and Kennedy's plan and who can get to [Arlen] Specter, [Susan] Collins, and [Olympia] Snowe first," says Edwards, referring to three moderate Republican Senators, who may support a major healthcare reform package.
Edwards says the toughest issue policymakers have to tackle is creating a standard benefit design. The feds can't mandate everyone have insurance and move the 47 million uninsured into existing commercial health plans because each state has its own required coverage mandates that require insurers provide certain services, such as maternity or cancer care.
Though state leaders have created the mandates as a way to assure residents are covered for such services as maternity and cancer care, the health insurance industry rails against mandates because it adds costs onto plans. Meanwhile, some states, including Florida, have created "mandate-lite" policies. These health plans limit the mandated services, which cuts costs and provides more affordable health insurance options for those uninsured.
To get the support of state delegations, such as New York and California, reform supporters will have to develop a richer standard benefit design, but that will also increase plan costs and raise the ire of those who oppose coverage mandates.
"I think this is their biggest challenge," says Edwards.
John Comminsis the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.Les Mastersonis senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.
A proposed bill that would make major changes in the U.S. abortion landscape has Roman Catholic bishops threatening to close Catholic hospitals if the Democratic Congress and White House make it law. FOCA, as the bill is known, would make federal law out of the abortion protections established in 1973 by the U.S. Supreme Court's Roe vs. Wade ruling. The legislation has some Roman Catholic bishops threatening to shutter the country's 624 Catholic hospitals rather than comply.