NCPA - National Center for Policy Analysis


March 10, 2009

The National Journal recently asked health policy experts what health care issue they would look back upon 10 years from now and really wish we had paid more attention to in 2009?

John C. Goodman, President and CEO of the National Center for Policy Analysis says that in the current health care debate, we are making three very big mistakes:

  • Believing that we can control health care costs without having anyone choose between health care and other uses of money.
  • Believing that we can improve quality without having providers compete for patients based on quality.
  • Believing that we can improve access by inducing people to drop their private coverage and join public plans that pay providers below market rates.

Raymond C. Scheppach, Executive Director of the National Governors Association believes that long term care is an important health care issue that is not getting enough attention now:

  • What most consumers and even many policymakers do not realize is that Medicare coverage for long term care services is extremely limited, leaving huge gaps in the types of services most elderly and disabled Americans need.
  • The absence of any national strategy has thrust the responsibility to the states and to the Medicaid program in particular; in turn, Medicaid now serves as the de facto long term system of care, spending more than $118 billion to provide services to more than three million individuals.
  • This also means our current system forces consumers to impoverish themselves in order to receive Medicaid long term care services.

Gail Wilensky, a senior fellow with Project Hope believes that inadequate standards-setting and other decisions to ensure true interoperability between certified electronic medical record (EMR) systems is an important issue that we're neglecting today:

  • Health IT is potentially a great enabler for comparative effectiveness analyses, clinical decision-support systems and many other strategies that could improve the inefficiencies in our current health care environment.
  • The stimulus bill contains $2 billion for the Dept. of Health and Human Services (HHS) to be used to for grants and loans to encourage the development of EMRs and $17 bill for Medicare to use for incentive payments to institutions and physicians.
  • However, much of this spending will be meaningless unless it is preceded by the necessary standard-setting decisions.

Source: John C. Goodman, Raymond C. Scheppach and Gail Wilensky, "What Big Mistake Are We Making?" National Journal, March 9, 2009.

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