Thursday, January 26, 2012

How Bad Budgets and Broken Politics Undermine Health (and what can be done about it)

Earlier today, the American College of Physicians released a report on the State of the Nation’s Health Care in 2012. The report makes the case that unwise budget choices and broken politics are undermining progress in reducing health care costs, improving health and expanding access. It calls on Congress to reverse across-the-board budget cuts (sequestration) that will have a devastating impact on programs to ensure public health and safety, conduct medical research, provide access to care for vulnerable populations, and address a growing shortage of physicians.

This was NOT a case, though, of ACP being another “special interest” complaining about budget cuts to favored programs. For one thing, we don’t believe that government programs to protect the public from natural and manmade health disasters and pandemics, ensure their food and drugs are safe, and help find cures for cancer and diabetes qualify as special interest “pork.” For another, ACP proposed an alternative plan to achieve hundreds of billions in budget savings that focus on the real cost-drivers: fixing a dysfunctional physician payment system, reducing the costs of defensive medicine, enacting structural reforms in Medicare and Medicaid, and reforming the tax system to encourage people to consider costs when choosing health benefits.

Many of ACP’s recommendations to reduce costs in a fiscally and socially responsible way have been endorsed by bipartisan commissions that have come up with plans to reduce the federal budget deficit. But the report notes that a broken political system that favors confrontation over compromise has made it nearly impossible to move forward on such common-ground solutions.

Rather than allowing politicians to continue to hide behind divisive rhetoric while ducking the real issues, ACP challenges them to answer three questions each about how they would improve health care quality and access and reduce costs. For Republican candidates, the questions focus on the unanswered “replace” part of “repeal and replace.” For President Obama and Democrats, the questions focus on possible changes to the ACA and their views on entitlement reform.

(You can find the report and all of its supporting materials here, including a slide deck that summarizes the key findings and recommendations.)

Realistically, ACP’s report is not going to lead to a “Hallelujah” moment when the politicians decide to deal responsibly with health and to seek bipartisan agreement of common-ground reforms. But through today’s report, ACP at least hopes to show them that there is a way forward.

Today’s question: What do you think of ACP’s assessment of the state of the nation’s health care, our proposals for a better way to reduce costs, and our challenge to the candidates?

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