-
Health Reform: We Need Details, President Obama
Tweet Share on Facebook May 26, 2009 Comment (55)By Bernadine Healy, M.D.
One thing that's clear from the political winds blowing at both ends of Pennsylvania Avenue is that the perceived secret to getting health reform done is to keep the details away from pesky critics until it's almost too late to say no. On this, President Obama and a select group in Congress have emerged as a phenomenal tag team. Obama is the frontman, speaking in great generalities and making pledges that are almost too good to be true, while those in Congress, emboldened by a nearly filibuster-proof Democratic majority, are at work behind closed doors on the nuts and bolts. The promise is that all Americans will soon be guaranteed affordable, high-quality healthcare and the freedom to choose whatever doctor or health plan they want, all at a savings of some $2,500 per family. This comes with an even broader assurance: the very salvation of our economy, which Obama preaches is doomed without the cost-tightening of health reform. But slow down here. We need to look critically at this sales pitch, because reform comes with a price that is only gradually being revealed.
At the moment, committees in the House and Senate are penning their sweeping legislation on a timetable that will not allow for a public viewing before mid-June. Passage is expected in July, in time for a presidential-congressional victory lap by summer's end. The reason for this breathtaking pace? A big one is the fear that if it doesn't happen fast, it won't happen—and that many of those who lived through the Clinton health plan debacle in 1994 believe that the devil in the revealed details of that plan sank it.
-
Swine Flu's Fall Return: 3 Steps We Must Take Now
Tweet Share on Facebook May 12, 2009 Comment (48)By Bernadine Healy, M.D.
The H1N1 virus, or swine flu, first brought to public attention a mere couple of weeks ago, quickly spread from its epicenter in Mexico to at least four other continents, 30 countries, and more than 5,000 people, reaching near-pandemic levels before subsiding. So far, the global outbreak of this novel strain, decoded by researchers as a mongrel mix of mostly swine, a touch of bird, and enough of human to make it jump from animal into people, has caused milder and less transmissible disease and far fewer deaths than originally feared. But it would be dangerous to assume that we are out of the woods.
Indeed, as the risk seems to abate, the public health focus must now shift promptly to the hard-to-gauge threat that this H1N1 influenza poses when flu season begins in the fall. And here our predictive abilities are no better than a coin flip. We have faced just three flu pandemics in the past century, two of which turned out not to be serious. But the pandemic of 1918 took half a million lives in the United States and, conservatively, 50 million worldwide. That virus, also an H1N1 strain, though of avian origin, first emerged in the spring like a lamb, only to return in the fall like a lion, having mutated into a fierce and deadly form. Granted, science and medicine were rather primitive at the time. But the experience is not something that public health officials can ignore. Margaret Chan, the director-general of the World Health Organization, said last week that she would rather be overprepared than have to answer questions after a deadly outbreak about why WHO did not take sufficient action.
-
Health Reform, Too Tough on Hospital Readmission
Tweet Share on Facebook May 1, 2009 Comment (22)By Bernadine Healy, M.D.
As President Obama has it, the nation's sick house is putting us into the poorhouse, and medicine seems not too far behind Wall Street in bringing on our economic woes. Thus, with a few swoops of the presidential pen, Obama has already laid the groundwork for a massive overhaul of America's healthcare system into a more publicly managed, cost-conscious enterprise that focuses more on wellness than sickness. And wellness does come cheap. Driving most government outlays, however, are the many millions of Americans—particularly the elderly—with extremely resource-intensive chronic diseases.
So far, no pain: The reform process meant to reduce the nation's $2.2 trillion annual healthcare spending currently has many belts expanding, not tightening. Billions are being poured into the proposed pillars of health reform—a national electronic medical record for all and comparative-effectiveness research programs that will guide more standardized and coordinated care. Some are skeptical that these will cut costs, but the jury's still out. What's tried and true, however, is the government's power to restrict reimbursement as a means of changing medical behavior. Medicare, which covers virtually all of the elderly by fiat (if elders don't buy into it, they lose their Social Security) has the power to say "No" to expensive treatments. That's great if the care is unnecessary. But the rub is that you can't always tell when you're not at the bedside or if you don't know the medical facts about a given patient.
advertisement
Featured Video
advertisement
