I promised in an earlier blog to list 10 things in the Senate version of the healthcare reform bill that you might not be aware of. Since it’s New Year’s Eve, technically a holiday, I’m only working at partial speed so you only get a partial list today. More to come over the next few days.
1. Support comparative effectiveness research by establishing a non-profit Patient-Centered Outcomes Research Institute to identify research priorities and conduct research that compares the clinical effectiveness of medical treatments.
In English: The government will fund research to directly compare treatment A to treatment B to determine which works best and is most cost effective.
Major weakness: the Senate bill specifically notes that the results of such research “may not be construed” as mandates, guidelines, or recommendations for payment, coverage, or treatment or used to deny coverage.
Huh? What is the point of finding out that treatment A works better than treatment B if you don’t use it to make coverage decisions???
Prediction: Most insurers will use this information to make coverage decisions, much to the chagrin of many pharmaceutical and medical device companies. In the not-too-distant-future, Medicare will join the party. After all, the eventual goal of all this is to improve quality and reduce costs, isn’t it?
2. Award five-year demonstration grants to states to develop, implement, and evaluate alternatives to current tort litigation. Preference will be given to states that have developed alternatives in consultation with relevant stakeholders and that have proposals that are likely to enhance patient safety by reducing medical errors and adverse events and are likely to improve access to liability insurance.
In English: The feds will give money to states to explore ways to get doctors to stop practicing defensive medicine so we can bring down malpractice insurance premiums and reduce litigation. You get more money if your proposal also focuses on ways to reduce medical errors (think: cutting off the wrong leg) and make it easier for docs to get malpractice insurance.
This is really important, because despite improved attention to the problem of medical errors over the past decade, we haven’t made all that much progress. And, as noted in an earlier blog, a huge number of ordered tests are unnecessary.
Prediction: We may finally be on our way to the tort reform we need in the healthcare system.
3. Develop a national quality improvement strategy that includes priorities to improve the delivery of health care services, patient health outcomes, and population health. Create processes for the development of quality measures involving input from multiple stakeholders and for selecting quality measures to be used in reporting to and payment under federal health programs.
In English. We’re going to tackle the quality issues within the healthcare system that Josh referred to in his comment. It is shameful that despite spending more per capita than any other country on healthcare, we are less than average in several key indicators.
4. Establish a grant program to support the delivery of evidence-based and community-based prevention and wellness services aimed at strengthening prevention activities, reducing chronic disease rates and addressing health disparities, especially in rural and frontier areas.
In English. This and other components of the bill, including grants to small businesses that implement wellness programs and a requirement that all chain and fast food restaurants post nutritional information about their menu items, begins to get at another major problem in our country and healthcare system: Lifestyle-related illnesses like diabetes and heart disease, and the lack of incentive for physicians to push prevention.
Prediction: The pendulum is swinging away from self indulgence towards restraint on fiscal terms in this country; maybe we’ll start seeing the same when it comes to our personal health.
Tomorrow: Six More Surprising Components of Healthcare Reform