Health-care provider reform is also vital to the effort

9/12/2009

THE battle of health-care reform rages on with no end in sight. The extraordinary amount of misinformation, scare tactics, lobbying influence, and congressional jockeying is an embarrassment to the American public.

The overall objective of providing basic health-care coverage to all uninsured Americans is a worthy goal that should have been accomplished years ago. The dilemma, of course, is how to pay for it.

Proponents of HR 3200, America's Affordable Health Choices Act of 2009, have stated that at least $850 billion in cost savings is projected through such means as use of electronic medical records; reducing fraud; improving preventative measures, and implementing health-insurance industry reforms. Based on my review, including laboriously reading HR 3200, I have concluded that the projected savings are exaggerated, while the future costs are understated.

While much focus is being given to health-insurance industry reforms, insufficient attention is being paid to health-care provider reforms, notably in the hospital, pharmaceutical, medical, and medical equipment industries. Major health-care reform is improbable without adequately addressing the provider side.

Toledo illustrates why health-care provider reform is necessary. Since the demise of mandated regional health-care planning, Toledo has witnessed the establishment of two small children's hospitals; the announced plan by a hospital system and group of physicians to construct a 30-bed hospital within a few miles of a modern 300-bed hospital that operates at an annual occupancy rate of 60 percent; the purchase last year of three additional da Vinci robotic surgical systems at a cost of $4.5 million, and the recent announcement that a heart transplant program will be implemented locally, despite the proximity of two well-established programs, i.e., the University of Michigan and Cleveland Clinic programs.

Other questionable, costly health-related projects are well known in the community. To be successful, health-care reform legislation should address the development of a rational health-care delivery system.

To be effective, health-care reform should also include pharmaceutical industry price controls. Without these controls, the pharmaceutical companies will be able to increase prices to offset their pledged dollars that received a warm welcome by some congressional leaders.

Billions of dollars could be redirected to more productive endeavors if limitations were placed on health-care industry advertising. In our country, more than $3 billion is spent on advertising annually by pharmaceutical companies. Hospital advertising is often long on unsubstantiated image building and short on substance. Much medical equipment advertising, such as for motorized wheel chairs, misleads the public. Other countries limit health-care industry advertising.

Moreover, a graduated health-care tax should be instituted that applies to all Americans, instead of the proposed tax that is only on the very wealthy. All Americans have a stake in resolving this issue, and the magnitude of the financial shortfall should require a contribution by all.

It is evident from watching the congressional hearings that many members of Congress do not understand the complexities associated with our current health-care system. They rely considerably for direction on health-care lobbyists, political campaign contributors, and health-care professionals who prefer limited change. Moreover, to paraphrase Sen. Max Baucus (D., Mont.) early on in the health-care deliberations, Congress does not have the will to pass health-care legislation that appears overly controversial.

After all of the political wrangling is over, the outcome will be passage by Congress of legislation that provides health coverage for all uninsured Americans. However, to achieve the sufficient number of votes, vital components necessary for major health-care reform will be excluded or compromised. Those who desire more substantive health-care reform need not despair. Look on the upcoming legislation as an incremental step. Congress will be back within the next few years debating the skyrocketing costs of health care.

Darryl Lippman was president and CEO of what were then Mercy Health Partners and St. Vincent Mercy Medical Center. He resides in Sylvania.