Wednesday, September 10, 2008

Congress is back

Congress was gavelled back to order this week for a short three week session before last election season push. I have my eye on the mental health parity bill. The House and Senate have resolved the benefit design issues and now they have to resolve the pay-go or funding issues. I expected that those issues would be resolved by now. But they haven't. The Kaiser Daily Health Policy Report tells us that the Senate Finance Committee is trying to find funding and that time is running out. CQ reports of talk about a lame duck session that principally is coming from the minority right now.

The Health Now! Coalition lead by former Rep. Nancy Johnson is pushing for health information technology legislation. Be careful what you wish for because, according to the Kaiser Daily Health Policy Report, Rep. Pete Stark (D Ca.) is thinking about financially penalizing health care providers who don't timely adopt electronic health records.

Newsweek columnist Robert Samuelson wrote an excellent column titled "Getting Real about Health Care." He makes two key points:

On average [according to data from Brookings economist Gary Burtless], annual health spending per person—from all private and government sources—is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest.Probably in no other area, notes Burtless, is spending so equal—not in housing, clothes, transportation or anything. Why is this? One reason: government already insures more than a quarter of the population * * * .Medicare is so large and influential that by altering how it operates, government can reshape the entire health-care system. This would require changes in rules and reimbursements to encourage more electronic record-keeping, better case management, fewer dubious tests and procedures, and a fairer sharing of costs between the young and the old. The work would be unglamorous and probably unpopular. But if the next president won't—or can't—do it, his presidency will fail in one fateful way.

HHS Secretary Leavitt made essentally the same point about reforming Medicare at a conference that I attended last Spring. In that regard, the Senate Finance Committee held a hearing yesterday on "Improving health care quality: an Integral step toward health reform. Healthcare IT News reports that "Transparency in healthcare, pay-for-performance (P4P) and healthcare IT are among the top ways experts say the country could overhaul its healthcare system to not only improve care, but also reduce costs."

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