Surgery News - December 2008 - (Page 6) S U R G E R Y NEWS • D E C E M B E R 2 0 0 8 THE THE E 20/20 / 0/20 M V SION ACS Takes Stand on Health Care Reform O SIO SION IO safeguard standards of care in an optimal and ethical practice environment. Therefore, the College’s position statement emphasizes that there is an urgent need to improve the quality of care for patients with surgical diseases, enhance safety, and reduce medical errors and adverse events. The American College of Surgeons also has had a long-standing policy supporting universal access to affordable, high-quality, safe surgical care that is delivered in a timely manner. To achieve this goal, the Statement on Health Care Reform asserts that our nation must have a well-trained and available surgical workforce. Furthermore, the College realizes that health care spending has been accelerating at a rate that is disproportionate to growth in other sectors of the national economy. The ACS’s policy statement maintains that the provision of highquality, cost-effective, safe, and appropriate care will require enhanced patient participation in health care decision making, as well as the development of a payment system that promotes value-based purchasing. Details about the specific activities that the College believes lawmakers should support and that the ACS is committed to carrying out may be viewed on the College’s Web site. Visit www. facs.org/ahp/hcreform08.pdf. The College anticipates that this statement will be a useful starting point for further negotiation and for the elucidation of ideas from the broad range of stakeholders. In other words, the College’s leadership views the Statement on Health Care Reform as simply one step in our efforts to effectively collaborate with patients, payors, other providers, and the business sector to create a better health care system—one grounded in the principles of quality, patient safety, efficiency, cost-effectiveness, and equitable access to care. ■ DR. RUSSELL is Executive Director, American College of Surgeons. ost Americans—regardless of prove care for surgical patients in this whether they are physicians, pa- country. I am pleased to report that the ACS tients, policy makers, or leaders in the private sector— agree that the cur- Health Policy Steering Committee anrent health care delivery system is bro- swered this charge by drafting a Statement ken. Consequently, the demand for re- on Health Care Reform. The statement outlines actions the College form is intensifying. In fact, urges Congress and the Adsome experts predict that the ministration to take conquestions of universal health cerning three goals for health insurance and the reform of care that are critically imporour health care system will tant and interrelated: quality become the focus of intense and safety, access/workforce, national debate shortly after and reduction of health care the inauguration of Presicosts. dent-elect Barack Obama The Board of Regents renext month. viewed the draft document Never has the time been so BY THOMAS R. during their meeting just beripe for physicians and other RUSSELL, M.D., FACS fore the 2008 Clinical Constakeholders to become actively involved in determining how to gress. The document was also shared with and reviewed by members of the transform our health care system. As one of the nation’s largest medical ACS Board of Governors at a first-ever associations, the American College of joint meeting of the Regents and GovSurgeons (ACS) recognizes its acute ernors. The College’s mission is to improve obligation to help policy makers understand what changes should occur to im- the care of the surgical patient and to Health Reform ’09: Sweeping Change or Step by Step? B Y J OY C E F R I E D E N Else vier Global Medical Ne ws WA S H I N G T O N — Can President-elect Barack Obama really shepherd through major health reform? Not until the Medicare physician payment system gets fixed, according to Robert Laszewski. “How do you plan a health care budget in Medicare and the private sector for years on out if you haven’t agreed on how you’re going to pay the doctors?” Mr. Laszewski said at a conference on the impact of the November elections sponsored by Congressional Quarterly and the Public Affairs Council. Unfortunately, many obstacles lie ahead before the payment system can be fixed, said Mr. Laszewski, president of Health Policy and Strategy Associates, a health care consulting firm. “The primary care physicians are clearly underpaid, and a lot of people think that the specialists are overpaid.” Although everyone agrees that the Medicare payment system needs to be reformed and that Medicare costs need to be trimmed, “the problem is, who’s going to give up the money?” he continued. “The definition of physician payment reform is to pay the primary care physicians more and pay the rest of us more, and that’s not going to fly.” Congress can’t keep making temporary fixes, Mr. Laszewski said, because a fix that lasts for, say, 3 years will be followed by a 36% fee cut because of the way the Sustainable Growth Rate (SGR) payment formula works. In the meantime, analysts and legislative aides are considering whether smaller health reforms might be possible. “Do you have to do something big?” asked Robert Blendon, Ph.D., professor of health policy and political analysis at the Harvard University School of Public Health, Boston. “I believe not, but it has to be something that looks like a big down payment.” And policy makers have to be clear about what their overall goals are, said Christine Ferguson, J.D., of the department of health policy at George Washington University, Washington. “There is a group of people who want to use health reform to improve health out- need to address both the cost and quality of health care comes; another group that wants to control costs [in and expanding coverage to the uninsured, Mr. Myers said. “It’s going to be kind of an organic process,” he said. terms of] the percentage of gross domestic product that goes to health care; and a third group that wants to pro- “I’m sure there will be fits and starts.” Prior to the election, aides to Senate Democrats tried tect people from high [out-of-pocket] costs,” she said. “So it’s very important we’re very clear about which of to lay the groundwork for this legislation by meeting with stakeholders from across the spectrum. And now those goals we’re trying to achieve.” Rather than passing a major health reform bill right that the election is over, Mr. Myers said there will be away, the panelists suggested that President-elect Oba- more discussions with Republicans in Congress. The interest in achieving comprehensive health rema could urge Congress to pass a package of smaller reforms, which could include less-controversial items as ex- form and the cooperation among stakeholders is highpanding the State Children’s Health Insurance Program er now than at any point in the last 25 years, said Ron (SCHIP), setting up a cost containment board to come Pollack, executive director of Families USA. “There’s a up with ideas for reducing health spending, and helping very significant likelihood that meaningful health reindividuals and small businesses buy health insurance— form will be a top and early priority for action in the 111th Congress,” Mr. Pollack said. possibly by giving them subsidies to help pay for it. ■ “These items are all no-brainers,” according to Mr. Laszewski. Mary Ellen Schneider, Elsevier Global Medical News, But some Senate Democrats are seeking a more ag- contributed to this report. gressive approach. Sen. Edward M. Kennedy (D- Mass.), who chairs the SenDATA WATCH ate Health, Education, Labor and Pensions Committee, wants to craft comProjected U.S. Health Expenditures prehensive health reform legislation that (in trillions of dollars) follows the framework of the Obama plan, said Michael Myers, staff director Total health expenditures 5 for the committee. Hospital care “With the Obama victory, the question Physician and clinical services 4 is no longer whether we’ll pursue comprehensive health reform but when and 3 exactly what form,” Mr. Myers said during a postelection briefing sponsored by 2 the advocacy group, Families USA. While many health reform proposals 1 are circulating on Capitol Hill, the best chance for success is a single-bill strategy, Mr. Myers said, and Sen. Kennedy is urg0 2007 2009 2011 2013 2015 2017 ing fellow Democrats to unite behind the proposal from President-elect Obama. Note: Based on 2006 National Health Expenditures data. No legislation has been drafted yet, but Source: Centers for Medicare and Medicaid Services whatever comes out of the Congress will ELSEVIER GLOBAL MEDICAL NEWS http://www.facs.org/ahp/hcreform08.pdf http://www.facs.org/ahp/hcreform08.pdf
Table of Contents Feed for the Digital Edition of Surgery News - December 2008 Surgery News - December 2008 Contents The 20/20 Vision: Health Reform News From the College: Nominations Thoracic: Breathing Easier Postop Management: Renal Failure Surgery News - December 2008 Surgery News - December 2008 - Contents (Page 1) Surgery News - December 2008 - Contents (Page 2) Surgery News - December 2008 - Contents (Page 3) Surgery News - December 2008 - Contents (Page 4) Surgery News - December 2008 - Contents (Page 5) Surgery News - December 2008 - The 20/20 Vision: Health Reform (Page 6) Surgery News - December 2008 - The 20/20 Vision: Health Reform (Page 7) Surgery News - December 2008 - The 20/20 Vision: Health Reform (Page 8) Surgery News - December 2008 - The 20/20 Vision: Health Reform (Page 9) Surgery News - December 2008 - News From the College: Nominations (Page 10) Surgery News - December 2008 - News From the College: Nominations (Page 11) Surgery News - December 2008 - Thoracic: Breathing Easier (Page 12) Surgery News - December 2008 - Thoracic: Breathing Easier (Page 13) Surgery News - December 2008 - Thoracic: Breathing Easier (Page 14) Surgery News - December 2008 - Thoracic: Breathing Easier (Page 15) Surgery News - December 2008 - Postop Management: Renal Failure (Page 16) Surgery News - December 2008 - Postop Management: Renal Failure (Page 17) Surgery News - December 2008 - Postop Management: Renal Failure (Page 18) Surgery News - December 2008 - Postop Management: Renal Failure (Page 19) Surgery News - December 2008 - Postop Management: Renal Failure (Page 20)
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