Strange political bedfellows have come together to draft a formula for dealing with spiraling health care costs in the U.S. iin A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment from the Bipartisan Policy Center (BPC).
The BPC was founded by Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. This report also involved Bill Frist, Pete Domenici, and former White House and Congressional Budget Office Director Dr. Alice Rivlin who together work with the Health Care Cost Containment Initiative at the BPC.
The essence of the 132-page report is that the U.S. health system is unsustainable as it is currently financed and delivered. The system must work to improve quality of care and eliminate “waste and overpayments” through becoming more coordinated and value-driven and move away from volume-based, fragmented care.
The authors say their approach is different as it does not specifically focus on federal deficit reduction but, instead, addresses four action categories:
- Improve and enhance Medicare to incent quality and care coordination through a new option in Medicare called “Medicare Networks” that would provide greater continuity-of-care and efficiencies and an “improved version of ACOs on steroids,” according to Rivlin (that is, Accountable Care Organizations). In addition, this line item would reform Medicare Advantage, incorporate more “carrot-and-stick” incentives into Medicare fee-for-service (FFS), and “modernize Medicare” by providing greater incentives for patients to seek care at the right time.
- Reform tax policy and clarify consolidation rules to encourage greater efficiency and competition by changing rules for Employer-Sponsored Health Insurance (ESI) and making it less regressive, along with adapting antitrust rules for local payors and providers to come together to develop integrated delivery systems within regulatory frameworks.
- Prioritize quality, prevention and wellness, especially through gathering and disseminating data to purchasers, including consumers, to enable transparency and good health care choice-making.
- Incent and empower states to improve care and constrain costs through delivery, payment, workforce and liability reform, especially to strengthen the primary care infrastructure (especially by loosening primary care scope of practice rules to providers beyond physicians), to improve the medical liability system and the practice of defensive medicine, and to promote transparency
The paper is meant to kick-off a “constructive dialogue” among policymakers to get on with fundamental health reform that will address costs, which most analysts of the Affordable Care Act believe won’t bend that stubborn, ever-increasing health cost curve,
Health Populi’s Hot Points: Tom Daschle was quoted in Kaiser Health News saying, “it’s too soon to predict how far this can go.” He, of all people, well understands how “bipartisan” can mean different things to different people depending on your lens onto “bipartisanship.
After all, it was largely Republicans who forced Daschle to withdraw his name from consideration for leading the Department of Health and Human Services in 2009. And Daschle has the scars of fighting for legislation in Congress for four terms then another 18 years in the Senate.
Here is Daschle working with Republican Senators Baker (known in his time as The Great Conciliator because he could work on a bipartisan basis), Dole and Frist, and getting to “yes” in a 100+ page policy document.
But can today’s climate in Congress be branded as this flavor of bipartisanship? If gun checks in a post-Newtown America can’t get them to “yes,” Daschle’s dose of sobriety saying, “it’s too soon to predict how far this can go,” is an understated reality-check.