Health care reform must be part of recovery plans

Posted Feb. 10, 2009, at 7:59 p.m.

It has become the morning — or even the mourning — routine. Over coffee, you scan headlines about job losses, tanking investment portfolios and a deepening recession. Leaders call for swift action to address the issue and debate tactics.

Overlooked in this debate is one critical component that must be addressed if the nation is to gain firm ground on the path to economic recovery. Stimulus packages won’t do the trick unless fundamental health reform is part of the economic recovery plan. If you’re in doubt about how vital this is, just ask any Maine business leader who pays for health coverage, a recently laid-off worker who has lost coverage, or one of your neighbors who cannot pay for private health insurance.

We often hear that our health care system is the best in the world. Unfortunately, the only place where we rank No. 1 is in having the most costly system of all developed countries. Health care expenditures are consuming our federal budget. Last year, the Congressional Budget Office estimated that if the current growth rates for Medicare and Medicaid continue unabated, by 2050 the entire federal budget will be subsumed by health care spending. Economic development, infrastructure improvements, education and other programs vital for a growing economy will come up short.

Typically we’d equate such high spending with getting the best care that money can buy, but we’re not getting real value for our investment. Other developed nations spend far less of their national income for health care yet their people enjoy longer life spans, better health, and provide coverage for everyone.

In a state-by-state comparison of health spending, Maine ranks near the top as one of the most costly. In 2004, health care spending per person in Maine was $1,257 higher than the national average, but our higher spending did not result in fewer hospitalizations, better disease detection and management, or better health out-comes.

Clearly, our health care system requires serious reform, but this can occur only if we can determine how to get better value — and better health — for each dollar we spend. And it starts with serious — and hard — discussions about how we can all have a hand in reining in spiraling health care costs.

Organizations from all sectors in Maine are taking a leadership role in driving this discussion forward. With support from the Maine Health Access Foundation, leaders representing consumers, businesses, providers, hospitals, insurers, policymakers and others are working collaboratively to develop and test an array of strategies to attenuate Maine’s skyrocketing health care costs. Under this initiative, organizations are charged with developing cost containment approaches that capture true savings, not just shift costs from one group to another. Their approaches focus on:

Building better transparency so consumers can prospectively review health insurance benefits to make more informed choices about coverage that fits individual and family needs.

Advancing policies so patients and families can get information on comparative price and quality measures so they can make better choices about care.

Developing new value-based payment models that will drive higher quality, accountability and enhance the role of primary care in day-to-day patient care.

Decreasing administrative cost and improving continuity of coverage for people in public coverage programs and promoting evidence-based prescribing practices by helping doctors, nurses, mental health providers and others get unbiased education and information from nonindustry sources so prescription practices are guided by science rather than marketing.

A recent Mercer analysis showed that the average total health benefit costs for Maine businesses rose 8 percent from 2007 to 2008 ($8,680 per employee in 2007 to $9,392 in 2008). Increases of this magnitude erase narrow profit margins and make it harder for Maine businesses to compete in a national and global marketplace. In this current climate where the unremitting rise in health care costs dwarfs the vertical rise of a Sugarloaf expert run, we can’t wait a minute longer to address this issue.

If we’re serious about overcoming the larger fiscal crisis it’s imperative to start flattening the curve of health care spending by reforming our health care system now. Without it, our chances for a full economic recovery are as illusionary as a Madoff investment.

Wendy Wolf is president and CEO of Maine Health Access Foundation. MeHAF’s mission is to promote affordable and timely access to comprehensive, quality health care, and improve the health of every Maine resident.

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