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 Category: AllMarkets Are VitalJune 15, 2007
Health policy guru Mark McClellan was the keynote speaker at our major conference yesterday at the National Press Club, answering with a resounding ?Yes!? the question we had posed in the title of our event, ?Is there a role for markets in health care??
Mark, together with three international and two other U.S. health policy experts, concluded that markets and consumerism must work together, here and in other countries, to solve the problems all developing nations are facing. ?Fundamental trends in health care are the same in the U.S. and Europe,? Mark said, especially cost pressures. He says the quantities of health care consumption are rising everywhere, but ?too often it's the wrong treatment at the wrong time, the overuse or underuse of effective technologies, and a failure to emphasize prevention.? Mark used the experience of Medicare reform to show that even government programs can be transformed by market forces -- a transformation he led as head of the Centers for Medicare and Medicaid Services. Flexibility in benefits, less government micromanagement, useful information for beneficiaries, and incentives to seek value are all key, as is government's role in getting payment policies right, including risk adjusted payments. The Galen Institute co-sponsored the sell-out luncheon with the International Policy Network, and a podcast of the full event is available as are summaries of the remarks by our three international speakers. There is so much good information here it is hard to summarize, but here are a few highlights:
************ It's hard to know where to start in answering the week's news reports:
And to show you what an erudite readership we have at Health Policy Matters, I received several responses from my challenge in the last newsletter to ?What's Latin for, 'There's no free lunch'?? The answer, by consensus: ?Nulla mensa sine impensa?. You all are so smart! Grace-Marie Turner RECENT NEWS ARTICLES AND STUDIES:
COALITION'S PLAN WOULD HARM SCORES OF LOW-INCOME SENIORS ?Americans United for Change would disproportionately harm millions of low-income seniors in its campaign to eliminate subsidies to Medicare Advantage,? writes Grace-Marie Turner today in a letter to the editor of The Hill. ?MA plans offer more comprehensive benefits than traditional Medicare, and studies show these plans are an especially important option for low-income and minority seniors,? writes Turner. Additionally, ?Medicare Advantage plans often cover a host of benefits that regular Medicare doesn't cover, such as vision and dental care, added preventive services, protection against catastrophic medical costs, and prescription drug coverage at no added cost,? she writes. ?Far from being a giveaway to insurance companies, the subsidies to Medicare Advantage create a valuable option for America's struggling low-income seniors.? DEBUNKING A FEW MYTHS ABOUT DRUG IMPORTATION Washington lawmakers in both the House and the Senate continue to debate the issue of prescription drug importation. Grace-Marie Turner's op-ed sorts through the myths and realities of drug importation and provides evidence to disprove five of the biggest myths about this issue. She uses study data to refute charges about counterfeit drugs, cost, and safety. ?Importation will do little more than import foreign price controls while exposing American consumers to unnecessary and dangerous risks,? concludes Turner. Jurgen Reinhoudt of the American Enterprise Institute cautions that Europe's pharmaceutical industry lags significantly behind its American counterpart and ?is in the midst of a long and steady decline.? Europeans could regain their innovative and competitive edge by removing stringent price controls and adopting certain aspects of America's thriving pharmaceutical sector, like a system of free pricing drugs, direct-to-consumer advertising of prescription drugs, a pool of active venture capital, and a limited role of government in the R&D process. MEDICARE: PAST, PRESENT AND FUTURE Medicare Trustee Tom Saving and Andrew Rettenmaier, both of Texas A&M University, outline the effects that potential avenues for reform would have on the Medicare trust fund. While they say no vehicle for reform is attractive, they do ?illustrate the need for fundamental rethinking of how Medicare is delivered to retirees.? The authors considered types of rationing where retirees would receive a defined benefit, bringing with it a defined rate of Medicare program growth. And they consider reform that would call on beneficiaries to ration their own consumption by moving Medicare towards a high-deductible policy with spending below the deductible paid through a personal spending account. The authors place the highest importance on reforms that would move to a Medicare program where workers prepay part of their retirement health care. BALANCING THE BUDGET ON THE BACKS OF CANCER PATIENTS? A recent proposal issued by the Centers for Medicare and Medicaid Services (CMS) would cut back sharply on Medicare's coverage of drugs that treat anemia, called erythropoiesis stimulating agents (ESAs), for cancer patients undergoing chemotherapy. ?If the proposed decision is implemented, Medicare would no longer pay for highly effective drugs for every cancer patient who would benefit from them,? writes Joe Antos of the American Enterprise Institute. ?ESAs are, financially, the biggest category of physician-administered drugs paid for by Medicare?it is sensible for CMS to monitor the use of those products,? writes Antos. ?But CMS has jumped past science and the Food and Drug Administration (FDA), which is responsible for ensuring the safety of our medicines, in its recent proposal,? he writes. ?Precipitous action by CMS before all the facts are evaluated would raise serious questions about the government's objectivity in making scientific judgments about the effectiveness of medical treatments,? writes Antos. ?The CMS action is breathtaking for its speed and its incursion into the practice of medicine,? he concludes. ?A more nuanced and flexible coverage policy is called for, one that does not take away an option for severely ill patients fighting cancer.? HEALTH IT The Pacific Research Institute (PRI), Progressive Policy Institute (PPI), and Center for American Progress each released papers discussing the onset of Health Information Technology. Personal and electronic health records are discussed as opening avenues to more effectively coordinate care, provide quality reporting, and establish a more patient-focused system of healthcare delivery. PPI cautions, however, that enhanced portability of medical records must be accompanied with amendments to the Health Insurance Portability and Accountability Act, giving patients the right to limit the health information that providers disclose to fully protect patients' privacy. 2006 STATE SNAPSHOTS State Snapshots is a web-based tool that was launched in 2005 by HHS' Agency for Healthcare Research and Quality to provide information on health care quality measures for all of the states. Using data from the 2006 National Healthcare Quality and Disparities Reports, the Snapshots are based on 129 quality measures ranging from preventing bed sores to providing antibiotics quickly to hospitalized pneumonia patients. For example, ?Utah ranks first for its low colorectal cancer death rate?[and] Montana ranks first for pneumonia vaccinations for seniors.? The statistics ?also underscore the reality that some shortcomings in health care quality are widespread.? On average, ?States reported that only about 59 percent of adult surgery patients insured by Medicare receive appropriate timing of antibiotics?[and] about 54 percent of men over 50 reported they ever had a flexible sigmoidoscopy or colonoscopy.? A state scorecard from the Commonwealth Fund finds that there ?are large gaps in quality of care, access to care, avoidable hospitalizations and costs, equity and healthy lives among states.? The report finds that Northeast and Upper Midwest states ?often rank high in multiple areas? but states concentrated in the South tend to have lower rankings. For instance, states with the highest rate of insurance coverage include Vermont, Maine, and Iowa, while the lowest ranked states include Arkansas, Texas, and Mississippi. UPCOMING EVENTS: Aiming Higher: Results from a State Scorecard on Health System Performance The Medical Arms Race Syndrome: The Role of Purchaser and Payer with Special Guest Leonard Schaeffer Elements of State Health Reform: Covering Kids Who Killed HealthCare? America's $2 Trillion Medical Problem-and the Consumer-Driven Cure Health Care on Film: Clips from SiCKO and Its Competitors Who Owns Your Health Care? Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org. If you wish to subscribe to this free weekly newsletter, update your address, or be removed from our list, please send an e-mail message to galen@galen.org. The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors. CommentsNo comments Add Comment |
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