President Obama on March 5 warned that greatest threat to the U.S. economy is the soaring cost of heath care and called on Congress to enact a comprehensive health reform bill by the end of the year. Obama, at a White House forum on health care, brought together approximately 120 lawmakers, healthcare providers, pharmaceuticals, insurance, consumer, labor and business groups to discuss measures to lower health care costs, improve the quality of health care and expand coverage.
Attendees offered several ideas for containing healthcare costs, which Obama said is the key ingredient for sustaining an economic recovery and increasing the number of insured. "If people think that we can simply take everybody who's not insured and load them up in a system where costs are out of control, it's not going to happen -- we will run out of money" at the federal and state level, the president said.
However, several participants argued the opposite view that increasing the number of insured or covering all the uninsured would lower costs. "You can't control costs unless everybody's covered," maintained Rep. Henry Waxman (D-Calif.), who said that failure to provide universal coverage would continue cost-shifting. Sen. Bernie Sanders (I., Vt.) contended that if every American had a doctor, "then costs will drop." Richard Kirsch, National Campaign Manager for Health Care for America Now, said there is a "false dichotomy between coverage and costs" and that covering more people would lower costs.
Containing healthcare costs will require a change in the current payment system, stressed Donna Shalala, President of the University of Miami and former Health and Human Services Secretary in the Clinton administration. Several attendees stressed a reexamination of end of life care and the need to establish uniform standards in terms of quality of care and the disparity of costs. Rep. Michael Burgess (R-Texas) recommended payment incentives for doctors who are successful in getting patients to fill out advanced directives during physical examinations. Karen Ignani, President of the America's Health Insurance Plans, said that all stakeholder organizations must commit to taking 1 to 2 percentage points off of the health spending growth curve. She also called for a commission similar to the one established for base closings to examine ways to decrease costs.
Establishing electronic medical records and increasing preventive care are among the areas of common agreement. Billy Tauzin, President and CEO of PhRMA, stressed that preventive care should be "pervasive in all the things we do, from schools, to workplaces to communities. Focusing on prevention would lower costs, improve care, reduce obesity, manage chronic care and "invest in comparative effectiveness," Obama noted at the conclusion of the health care forum.
Legislative timeline
On health care legislation, Obama stressed that a final package must include a combination of public and private participation. The president also made clear that the White House will be offering goals and principles for a healthcare bill, but is leaving it to Congress the craft the package. The Senate Finance Committee is planning to mark up a bill in June.
"Every idea must be considered. Every option must be on the table. There should be no sacred cows in this discussion," Obama said. However, White House Press Secretary Robert Gibbs, at a press briefing on March 5, threw cold water on the idea of a single payer system, advising that the president does not believe that is the best way to cut healthcare costs and increase access.
Regarding Medicare and Medicaid reform, Obama said he did believe it is possible to overhaul the entitlement programs effectively without fixing the underlying problem of health care inflation first.
"We spend more per capita than any nation on Earth. And to find that American solution that mixes public and private, but also says we shouldn't have such an inefficient system and we should make investments today to ensure that we're saving money down the road, that's going to be our challenge," Obama stated.
CCH Washington Bureau, March 6, 2009.
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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