President Barack Obama wants a health-care reform bill on his desk before Congress takes its August break, and his deadline has prompted a sizzling summer debate over how to cut costs, raise revenues and extend coverage to more Americans. Not surprisingly, some ideas are good – and some aren’t.
As last week’s rebellion by conservative and moderate Democrats demonstrated, sorting the good from the bad won’t be all that easy – especially over hot-button issues such as whether the federal government should be allowed to sell insurance in competition with private companies, a likely first step down the path to government-run health care.
Fortunately, some building blocks can help form political consensus before Washington’s notorious summer heat melts the chances for progress.
The movement toward digitizing medical records, which first gained federal support when former Wisconsin Gov. Tommy Thompson was secretary of Health and Human Services, has picked up steam under Obama. Electronic health records will provide a long-term foundation for higher quality care while reducing errors and giving medical professionals better data. It’s a ready example of how technology can help patients.
A related patient-friendly idea is the Comparative Effectiveness Research Act of 2009. This bill (H.R. 2502) will ensure that doctors and patients will have the best information available to them to determine the proper course of treatment for each individual patient.
The basic idea behind "comparative effectiveness" is to create a national database to share information about how different therapies, treatments and diagnostics work for patients. Medical professionals would have near-instant access to that information, which would help them tailor treatment plans for their patients.
"Comparative cost-effectiveness information would enable physicians and patients to make more informed health care decisions," the American Medical Association noted last year. "Such information could also be used by insurers, employers, government entities, educators, and others seeking to prioritize which diseases to target, recognize overuse and underuse of specific services, and identify preventive services and treatments demonstrated to yield positive return on investment."
Comparative effectiveness wouldn’t limit treatment options or keep new technology out of the market. But it should expand patient options by allowing doctors to find out about cutting-edge treatments and therapies that worked in similar cases. The database should alert patients to what works and warn them about what doesn’t – saving time and money in needless treatments.
Patients and physicians would still control treatment options. In fact, they would have more control, because they would be able to learn more about possible options before they tried them.
Moderate and pro-business Democrats such as the "Blue Dog Coalition," which stood up to Speaker Nancy Pelosi last week, back comparative effectiveness. U.S. Rep. Ron Kind, a Democrat who represents Wisconsin’s 3rd Congressional District, is a co-sponsor of the Comparative Effectiveness Research Act.
If it becomes a part of the health-care reform mix, this bill will enhance information about treatment options while closing the patient "information gap." It will focus on communicating research results to patients and providers versus making centralized coverage and payment decisions. It will provide information on clinical value and patient health outcomes. It will support medical advances such as personalized medicine. And it will recognize the unique nature and value of targeted therapies that may help people with rare diseases.
Wisconsin is something of a microcosm when it comes to health care in America. It has all of the access, cost and quality of care challenges found in most states – and it also has many pieces of the solution, as well. The state is among the top 12 nationally in academic research and development spending, in good part because so much of that R&D is conducted in areas tied to human health. It has some of the largest private clinics and public hospitals in the region. It has a thriving biotechnology sector, and has become one of the nation’s top 10 states in medical device and equipment manufacturing. It is also a center for electronic medical records, thanks to innovation by institutions ranging from the Marshfield Clinic to GE Healthcare to Epic Systems.
Comparative effectiveness offers a way to leverage assets such as those while creating a more responsive, innovative system. In the heat of the health-care debate, let’s hope cooler heads keep this idea alive.
Tom Still is president of the Wisconsin Technology Council.