November 14, 2008

Senate Finance Chairman Unveils Health Reform Blueprint

This week, Senator Max Baucus (D-MT), chair of the Senate Finance Committee, released a blueprint for reform of the nation's healthcare system. Release of the plan, which does not include legislative language, follows a series of hearings and a June health summit convened by the Finance Committee. Healthcare reform is expected to be a top priority for the 111th Congress and the new administration. The Senate Health, Education, Labor and Pensions Committee, chaired by Senator. Kennedy (D-MA), is developing its own legislative proposal and is expected to be released early in the new Congress. It is expected that this proposal will mirror President-elect Obama's healthcare reform plan.

The goals of the Baucus plan are to achieve universal coverage within 10 years, reduce healthcare costs and improve the quality of care. Under the plan, health insurance coverage is required for all Americans,and it calls for a Medicare buy-in, expansions of Medicaid and the State Children's Health Insurance Program for those not insured through the employer-based system. The key mechanism for universal coverage is the creation of a national insurance pool, called the Health Insurance Exchange, which will provide subsidies for some families and individuals and small businesses. Prevention is emphasized as one of the keys to reducing health costs, and preventative care would be guaranteed through the Health Insurance Exchange and in Medicaid, Medicare and SCHIP.
Senator Baucus proposes a number of reforms to achieve high quality, cost-effective healthcare. He supports gradually shifting the Medicare payment system from pay for reporting to pay for performance, and points to CMS's November 2007 Report to Congress for the roadmap on how to facilitate this change. He also calls for an expansion of the patient-centered medical home model, involving collaboration between Medicare and sites of the current demonstration projects of this model with private payers and Medicaid. By restructuring the sustainable growth rate, the Baucus plan provides a permanent fix to the Medicare physician.

Senator. Baucus would fund investments in comparative effectiveness research, health information technology and the healthcare workforce.His plan recommends the creation of an independent nongovernmental institute to conduct comparative effectiveness research to guide evidence-based care-an idea he already introduced in another bill (S.3408). To address physician workforce shortages, Senator. Baucus recommends a re-evaluation of the Medicare GME system, including options for increasing the residency cap for specialty areas and strengthening public health programs to expand diversity in healthcare the workforce.

Finally, the Baucus plan envisions lowering healthcare costs through prevention, restructured payment incentives and adoption of health information technology. Additional measures to rein-in costs are recommended, including initiatives to eliminate fraud, waste and abuse in government programs; increased public information about healthcare price; medical malpractice reforms; elimination of overpayments to private Medicare insurers and utilization of tax incentives for health coverage.

The entire Call to Action can be viewed through the Senate Finance Committee Web site at http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf

Public Health: CDC Releases COPD Mortality Data

This week the Centers for Disease Control and Prevention (CDC) released new data on COPD mortality rates in the U.S.(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a4.htm)

The CDC data shows mortality rates for men are leveling off or declining while mortality rates for women continue to rise. This confirms the finding of a similar 2002 CDC report on COPD trends. States with the highest death rate for COPD include Idaho, Indiana, Kansas, Kentucky, Maine, Montana, Nevada, Ohio, Oklahoma, Vermont, West Virginia and Wyoming.

In related news, the National Heart Lung and Blood Institute (NHLBI) released survey data showing that Americans are more familiar with COPD,but that knowledge gaps about the disease persist. Today, 74percent of those surveyed had heard of COPD, compared to 49 percent in 2004. While name recognition of COPD appears to be increasing, the public is still largely unaware of key symptoms of COPD,including chronic cough and shortness of breath,and that smoking is a key risk factor for developing COPD.

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