Surgery News- July 2008

4 SURGERY NEWS • J U LY 2 0 0 8 THE VISION Evolutionary Changes in Surgical Practice Private Groups Roll Out Health Care Reform Plans B Y M A RY E L L E N S C H N E I D E R 20/20 Else vier Global Medical Ne ws M ore and more players in the health care arena are unveiling plans to provide health care coverage for all or most Americans. For instance, the Commonwealth Fund’s “Building Blocks” proposal seeks to cover 44 million of the 48 million Americans estimated to be uninsured in 2008 through a national health insurance connector that would allow small businesses and individuals without large employer insurance to shop for a health plan. The connector would feature both private plans and a “Medicare Extra” option. The Medicare Extra plan would offer premiums of $259 a month for individuals and $702 a month for families, 30% lower than the average premium charged to employers today, according to the Commonwealth Fund, a private foundation that supports research on health policy reform. The plan also calls for expanding Medicaid and the State Children’s Health Insurance Plan (SCHIP) to cover all adults and children below 150% of the federal poverty level. And the plan would include both individual and employer mandates for health coverage. Using modeling from the Lewin Group, officials at the Commonwealth Fund estimate that the proposal would add $15 billion to current total health spending in the United States during the first year and about $218 billion over 10 years. But the plan could actually save $1.6 trillion over 10 years if it is combined with other reforms, according to the Commonwealth Fund. “This approach builds on group insurance coverage and the national reach of Medicare and at the same time addresses the high administrative and premium costs for individuals and small groups,” Karen Davis, Commonwealth Fund president, said in a statement. In the meantime, the Healthcare Leadership Council, a coalition of hospitals, health plans, and pharmaceutical and device manufacturers that aims to improve the quality and affordability of health care, has brought forward its own market-based proposal aimed at covering all Americans. Called “Closing the Gap,” the proposal calls for subsidies and tax breaks to help individuals afford coverage, improving health care quality through health information technology and care coordination, and realigning the financial incentives in the health care system to pay for value. For example, the plan calls on the government to provide premium subsidies to help employees afford their employer-sponsored insurance premiums. The plan also calls for applying the same tax breaks to individually purchased health insurance as apply to employer-sponsored coverage. However, the group did not endorse individual mandates for health insurance. The plan also calls for a shift from rewarding physicians and hospitals for the volume of services they provide to focusing on evidence-based care and prevention, Dr. Denis Cortese, chair of the Healthcare Leadership Council and president and chief executive officer of the Mayo Clinic, said during a press briefing. ■ Candidates’ Health Plans Leave Cost Questions Unanswered B Y A L I C I A A U LT Else vier Global Medical Ne ws WA S H I N G T O N — While health care has been a key issue in this year’s presidential campaign, plans from both Barack Obama and John McCain are light on specifics about how to control costs, and improve efficiency and productivity. The candidates’ wish lists provide few details on how they would accomplish the “fundamental change needed for our delivery system,” said Paul B. Ginsburg, Ph.D., president of the Center for Study- ing Health System Change, at a briefing sponsored by the Alliance for Health Reform. “They could have a debate over how best to do that,” he said. Economists have estimated that over the next decade, U.S. health spending will double from $2.2 trillion to $4.3 trillion. Dr. Ginsburg, along with Princeton University economist Uwe Reinhardt and former Centers for Medicare and Medicaid Services Administrator Dr. Mark McClellan, said that rising costs are largely being driven by variations in practice, growth in volume, and intensity of services. Senator Obama has said that he favors health information technology, transparency of price, promotion of quality care, chronic care coordination, payment reforms for value, malpractice reform, and promotion of generics. Most of these are old, but not worthless, ideas, said Dr. Reinhardt, James Madison Professor of Political Economy at Princeton. “These are not to be laughed off, but they won’t get us out of the box,” he said. Dr. Reinhardt called Senator McCain a “true radical” for his proposal to eliminate 2008 Coding Workshops American College of Surgeons 2008 Coding Workshop Series for Surgeons and Their Staff For more information and to register, go to DALL A S DALLAS, TX AUGUST 7 2008 Introduction to CPT, ICD-9-CM, and Evaluation and Management Coding AUGUST 8 2008 Surgical and Ofﬁce-Based Coding and Reimbursement (Advanced) C H ICAGO CHICAGO, IL SEPTEMBER 18 2008 Introduction to CPT, ICD-9-CM, and Evaluation and Management Coding SEPTEMBER 19 2008 Surgical and Ofﬁce-Based Coding and Reimbursement (Advanced) http:// www.facs.org/ ahp/workshops/ index.html or contact Debra Mariani, Practice Affairs Associate, tel. 202/672-1506, e-mail dmariani@facs.org the tax exemption for employer-provided health insurance. Individuals who purchase insurance on their own would instead receive a $2,500 tax credit; families would receive $5,000. “This is almost un-American—to take away a tax preference,” said Dr. Reinhardt, adding that it is “a shocking idea and not easy to get through Congress.” Dr. Ginsburg called the proposal “a potentially powerful idea,” saying that it could make consumers more sensitive to the cost side of insurance, and thus make them a more potent demand force. There will be no new federal money available to increase access to insurance or initiatives aimed at improving quality or productivity, said Dr. McClellan. “Next year is going to be a very tight year fiscally,” he said. He added that new spending will be next to impossible, especially for a Republican who, politically, must maintain the tax cuts instituted in 2001, and continue to fund the war in Iraq and the war on terrorism. In fact, tax reform, the Iraq war, and the economy are likely to be higher up on the campaign agenda than health during the general election run-up this fall, said Dr. McClellan and his fellow panelists. “I’m not persuaded that health care, in fact, will drive the campaign in the fall,” said Dr. Reinhardt. But Dr. McClellan said, “My hope is it doesn’t get pushed to the back burner. It will be a major missed opportunity if we don’t have health reform next year.” ■ http://www.facs.org/ahp/workshops/index.html http://www.facs.org/ahp/workshops/index.html http://www.facs.org/ahp/workshops/index.html http://www.facs.org/ahp/workshops/index.html http://www.facs.org/ahp/workshops/index.html

Table of Contents Feed for the Digital Edition of Surgery News- July 2008

Surgery News- July 2008 Contents The 20/20 Vision: Health Reform Trauma: Airway Anchor News From the College: Jacobson Winner General Surgery: Worth the Trouble

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