Blog | Tuesday, March 2, 2010

One expert's view on the prospects for reform


This week I'm attending the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium here in Philly. (If only they had invited the transitions of care folks, they could have covered every hot-button issue in medical practice.)

The opening lecture, by Health Affairs editor Susan Dentzer, was meant to be an overview of health system change, but not surprisingly, the focus was on one obvious potential source of change--pending health care reform legislation. She saw the major accomplishment of last week's summit as convincing the "three or four people who might have believed in a bipartisan solution" that it wasn't going to happen.

She rated the chances of Obama's new reform plan passing at about 50-60%. One of the major stumbling blocks will be abortion coverage, she predicted. Obama's proposal adopts the Senate's provision, which would allow abortion coverage in the new health exchange plans, as long as it was paid for out of a separate premium, not government funding. (In other words, women who want to be covered if they have an abortion would have to write two checks every month, Dentzer explained.) House members who inserted a provision banning coverage of abortions might balk at that.

Dentzer put her bad news for the other side of the political spectrum poetically. "It looks like the public option is dead even if the body is still twitching and may continue for the next few weeks."

As for the mass of the populace in the middle, they continue to be confused about what they want, Dentzer said. She reported on a Kaiser survey completed in Massachusetts the day after Scott Brown's election. 68% of the respondents said they supported Masschusetts' universal coverage system, but 48% opposed national health reform, which would basically expand the Massachusetts model to the rest of the country. Hunh?

Whatever happens with the current legislation, the pressure will still be on those in the industry to reform health care to deal with the major problems of cost, quality and access, Dentzer told the audience of health care business leaders.