After just 15 months as president and chief executive of Illinois-based Loyola University Health System, Paul Whelton, MD, is moving to re-energize its major teaching hospital complex. Whelton next step is $1 billion strategic plan to bolster Loyola's teaching, research and clinical programs. The 10-year plan includes money to convert the main hospital to all private rooms as well as additional resources to bolster its network of suburban outpatient medical-care sites and $100 million for a research facility to retain and attract top-notch medical researchers.
Sen. John McCain kicks off a week of healthcare pegged events with the message that the fundamental problem facing the healthcare system is spiraling costs that must be brought under control. Sens. Hillary Clinton and Barack Obama are proposing many of the same things that Sen. McCain supports as well. But healthcare experts say it is unclear how many of the presidential candidates' ideas could actually make a dent in the rising cost of care, particularly in the short term.
To improve their finances, many hospitals are adopting a policy that makes medical care contingent on upfront payments. Providers are pointing to their burgeoning bad-debt and charity-care costs as reasons for the change. Hospitals also have turned to the practice because of a spike in patients who don't pay their bills: Uncompensated care cost the hospital industry $31.2 billion in 2006, up 44% from $21.6 billion in 2000.
Drug and medical device companies should be banned from offering free food, gifts, travel and ghost-writing services to doctors, staff members and students in all 129 of the nation's medical colleges, says the Association of American Medical Colleges. The proposed ban is the result of a two-year effort by the group to create a model policy governing interactions between the schools and industry. Schools can ignore the association's advice, but most follow its recommendations. The rules would apply only to medical schools, but they could have enormous influence across medicine, said Dr. David Rothman, president of the Institute on Medicine.
One in four Americans who don’t have health coverage are eligible for Medicaid and the State Children’s Health Insurance Program but aren’t enrolled, according to a report from the National Institute for Health Care Management Foundation. The lack of enrollment was due to being unaware of the programs, not knowing how to enroll, fear of being linked with a publicly financed program, and the difficulty of staying enrolled, the report said.
Republican presidential candidate John McCain is opening a week-long U.S. campaign swing to focus on his healthcare proposals, and the first stop is a visit to a Miami children's hospital. McCain will argue the way to improve U.S. healthcare coverage lies in lowering costs and increasing competition rather than the "big-government" schemes he says the Democrats advocate. McCain's plan would concentrate on reining in costs and expanding access and would include a tax credit of $2,500 for individuals and $5,000 for families. It also would aim to increase competition and innovation and make it possible to buy coverage through any organization or association.
The Federal Trade Commission said it supports a bill that would eliminate Florida's certificate of need requirements for hospital construction. In written testimony to the state Senate, the FTC said certificates of need can be detrimental to competition and healthcare consumers. Florida's current CON law "places significant regulatory burdens on the development or improvement of a very broad class of healthcare facilities that otherwise might develop dynamically in response to market needs," according to the FTC statement.
More than half of the small businesses responding to a survey from a Midwest payroll firm indicated that offering company healthcare for employees is too expensive. In addition, the survey indicated that fewer small businesses are offering healthcare than even two years ago. One out of five small business owners surveyed reported having at least one person turn down a job offer because healthcare was not included.
The University of Pittsburgh Medical Center is getting set to attach its gold-and-white "UPMC" logo to all three sides of the 64-story U.S. Steel Tower, giving the region's largest employer visibility for miles around. UPMC is paying for the design, fabrication, erection and maintenance of the sign, but declined to discuss the $750,000 figure it submitted to the city planning commission for the sign's development. UPMC runs 20 hospitals in the Pittsburgh area and the new signage provides "tangible evidence of Pittsburgh's transformation into an international center of medicine, technology and education," according to a UPMC statement.
Politics is the art of numbers. Polls turn into voters, and power to govern often is the sum of the number of voters who care about a particular issue.
Few seem to care about healthcare.
At least no one outside of the people most affected by it—the uninsured. An Associated Press exit poll this week of Democratic voters found that 14% rated healthcare as the most important issue, trailing far behind the economy (55%) and Iraq (27%).
It does not take a statistician to know that there are an estimated 45 million of the 303 million Americans without health coverage, which makes for a percentage of roughly 14%. A true statistician may argue that extrapolating a preference poll and comparing it to a statistical designation is at best a mere coincidence. But scientific or not, the numbers hint that healthcare has so far failed to latch on as an issue with sustainable heft in the presidential campaign beyond those Americans most directly affected by it.
The reasons why are varied. Few would suggest that healthcare would or should trump either an ongoing war or a deteriorating economy as the issue of most concern to the American public. Indeed, I suspect that $4-a-gallon gasoline will still be on voters’ minds as they drive to the election precincts this fall.
The endless war of attrition on the Democratic side is preventing either candidate from seizing the high ground on healthcare, and pundits seem to suggest that the fight will continue at least until early summer. Meanwhile, much of Republican nominee-in-waiting John McCain’s healthcare fix is still a work in progress.
In the 2004 election, much of the steam on healthcare got lost behind same-sex marriage and other hot buttons that are easier to punch. Healthcare also lacks the immediate, universal pain points that hit everyone at the same time—like gas prices that cause travel, food and other out-of-pocket costs to rise quickly. The numbers of uninsured creep up and healthcare costs continue to rise. So having healthcare polling in the low double-digits this late in the 2008 campaign sets the debate up for much the same result as 2004 with no real mandate from voters for reform.
So what could change the picture and raise healthcare as an issue between now and then? If Hillary Clinton manages to capture the Democratic nomination, then the healthcare debate becomes a polarizing debate between Clinton’s universal coverage versus McCain’s quality and cost focus. Both candidates will attempt to tie in the rising cost of healthcare a threat to national prosperity, and perhaps rightly so. And it could get ugly. It could make Harry and Louise look like Ozzie and Harriet.
