Stunning Healthcare Overture from Bipartisan Group of US Senators - 2007

Healthcare Legislation in This Congress? - Michael Barone (usnews.com)

I followed Ezra Klein's link to this letter from 10 Senators, 5 Republicans and 5 Democrats, written just two years before President Obama took office! Read it, as it is stunning how far the Republican Choo Choo has gone around the bend.  [Courtesy USNews.com and Michael Barone.]

Now Wyden and nine other senators, five Democrats and five Republicans, have sent the following letter to Bush. Very interesting.

In addition to Wyden, the letter was signed by Republicans Jim DeMint of South Carolina, Robert Bennett of Utah, Trent Lott of Mississippi, Mike Crapo of Idaho, and John Thune of South Dakota, and Democrats Kent Conrad of North Dakota, Ken Salazar of Colorado, Maria Cantwell of Washington, and Herb Kohl of Wisconsin.

The text of the letter follows:

February 13, 2007

The Honorable George W. Bush
1600 Pennsylvania Avenue
Washington, D.C. 20500
Dear Mr. President:

As U.S. Senators of both political parties we would like to work with you and your Administration to fix the American health care system.
Each of us believes our current health system needs to be fixed now. Further delay is unacceptable as costs continue to skyrocket, our population ages, and chronic illness increases. In addition, our businesses are at a severe disadvantage when their competitors in the global market get health care for "free."
We would like to work with you and your Administration to pass legislation in this Congress that would:
1)Ensure that all Americans would have affordable, quality, private health coverage, while protecting current government programs. We believe the health care system cannot be fixed without providing solutions for everyone. Otherwise, the costs of those without insurance will continue to be shifted to those who do have coverage.
2)Modernize Federal tax rules for health coverage. Democratic and Republican economists have convinced us that the current rules disproportionately favor the most affluent, while promoting inefficiency.
3)Create more opportunities and incentives for states to design health solutions for their citizens. Many state officials are working in their state legislatures to develop fresh, creative strategies for improving health care, and we believe any legislation passed in this Congress should not stymie that innovation.
4)Take steps to create a culture of wellness through prevention strategies, rather than perpetuating our current emphasis on sick care. For example, Medicare Part A pays thousands of dollars in hospital expenses, while Medicare Part B provides no incentives for seniors to reduce blood pressure or cholesterol. Employers, families, and all our constituents want emphasis on prevention and wellness.
5)Encourage more cost-effective chronic and compassionate end-of-life care. Studies show that an increase in health care spending does not always mean an increase in quality of outcomes. All Americans should be empowered to make decisions about their end of life care, not be forced into hospice care without other options. We hope to work with you on policies that address these issues.
6)Improve access to information on price and quality of health services. Today, consumers have better accessto information about the price and quality of washing machines than on the price and quality of health services.
We disagree with those who say the Senate is too divided and too polarized to pass comprehensive health care legislation. We disagree with those who believe that this issue should not come up until after the next presidential election. We disagree with those who want to wait when the American people are saying, loud and clear, "We want to fix health care now."
We look forward to working with you in a bipartisan manner in the days ahead.

Skyrocketing costs! Competetive disadvantage! Universal access to health care! Class warfare! Inefficient US health care! Wellness! Prevention! Cost effectiveness! Compassionate end of life care! Expanding palliative care services! Health care in the US is broken!

Who knew Jim DeMint was a socialist before he was a Tea-Partier?

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Attacks on Dartmouth Atlas Rebutted

Health Affairs Blog:

"[HA Blog]Editor’s Note: In the post below, Amitabh Chandra responds to criticisms of the Dartmouth Atlas and offers his vision of the lessons of the Dartmouth findings on variations in health care costs and practice styles. Watch the Blog tomorrow for a roundtable discussion on Atul Gawande’s New Yorker article on McAllen Texas and the policy implications of the Dartmouth work. Roundtable participants will include Robert Berenson, Elliott Fisher, Robert Galvin and Gail Wilensky."

I heard Sen. Judd Gregg this AM on CSPAN pontificating at the Budget Committee meeting on health care, fretting that any kind of health board would result in "control" of health care by "Washington". If it's staffed by people like Dr. Chandra, we'll be OK.

But, more to the point, he still lives in the DC bubble fantasy land where he thinks patients have control of their health care, and not the private health insurers. He worries about a board being formed to guide decision making by clinicians. I think this is absolutely critical to reigning in health care costs, though, as Dr. Chandra so clearly indicates, this is as complex a set of problems as we're ever going to face in our life times, so it will require multiple iterations of progress to get where we ultimately wish to go.

And that was another thing Gregg lamented: the complexity of the bill. If he wants straight-forward, then HR 676 is his bill. But I'm guessing a single payer system is a non starter for him. So, given that we're talking about 20% of the economy, it's gonna be a complex solution!

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