Sen. Gregg on Health Care

July 16, 2009Tom DeRosa

U.S. Senator Judd Gregg (R-NH), a senior member of the Health, Education, Labor, and Pensions Committee (HELP), commented on the HELP Committee’s reporting of the Kennedy-Dodd Affordable Health Choices Act with only Democratic votes.

Senator Gregg stated:

“When he assumed office in January, President Obama stated that reforming our nation’s broken health care system was one of his greatest and most urgent priorities. I couldn’t agree more. The severity of our broken system is easily illustrated when you look at the fact that we spend trillions of dollars on health care—more than 17% of our gross domestic product –and nearly 47 million Americans are uninsured.

“To reach the goal of providing meaningful health care reform for all Americans, the President established three benchmarks: one, insure all Americans; two, enable folks who already have insurance they like to keep it; and three, reduce health care spending and improve quality. Many in Congress and across the country believe these benchmarks are critical and can be achieved.

“Unfortunately, the health reform bill offered by the Democratic majority of the Senate HELP Committee fails to address any of these goals and actually makes our broken system worse. This legislation massively expands the federal government, and then sends the bill, worth trillions, to future generations for them to pay. It fails to cover all who are uninsured – leaving an estimated 34 million without care; causes millions who like the insurance they have through their employers to lose it; and fails to implement effective practices or needed controls in how we pay for health care to reduce the growth in health care spending.

“We have a estimate for some, but not all, sections of the bill – and the partial estimate shows it increases spending by more than $868 billion in the first ten years. Besides being incomplete for the first 10 years, what is more disturbing is that the estimate fails to reflect the true cost of the fully-implemented plan, which will ring in at more than $1.5 trillion over ten years without including an expected Medicaid expansion of $500 billion. Yet, the economic impact goes beyond these costs, as employers will now be forced to foot the bill for government -mandated insurance coverage, resulting in higher fees for employers and employees alike, reduced wages, or worse—job loss because employers simply cannot afford to insure their employees. The consequences of this backward action are especially harsh at a time when millions of Americans are out of work and the unemployment rate continues to rise.

“Further, this partisan bill will have a negative impact on the high quality health care and innovation we have become accustomed to in the United States. It moves us closer to a single-payer system where choice of care, treatments, and even a patient’s personal doctor will be mandated by a bureaucrat in Washington D.C.

“This supposed health care fix is a health care failure and a disaster for the American people. It spends trillions and fails to adequately address the President’s own goals for health care reform. We still have time to turn this process around instead of steamrolling our country into a sub-par government-run plan, but it will require serious action from Democrats and Republicans and a pledge to put politics aside for the health of all Americans and our nation’s fiscal future.”

Though the legislation is flawed, Senator Gregg was able to improve the legislation in areas of cost and quality. Here’s how: 

  • Data Analysis.  To truly understand how our health care system is performing, it is essential to understand the clinical data on how patients are treated and if those treatments work, and also the reimbursement claims data which reveal how much treatment patients receive.  It is through the combination of claims data and quality data that we know that certain providers perform higher quality care at a lower price.  This formula has been reported to be highly effective by the Dartmouth Institute for Health Policy and Clinical Practice.To address this need, Senator Gregg developed Section 205 of the bill with Senators Kennedy and Mikulski based on the Medicare Quality Enhancement Act which Senator Gregg introduced in the 110th Congress.  This section will create incentives to collect and analyze health care clinical and claims data to measure how providers like hospitals and physicians perform on quality and resource use.
  • Readmissions.  The rate of hospital readmissions is directly related to the quality of the care patients receive at a facility.  To address this challenge, Senator Gregg developed Section 216 with Senator Kennedy which will require private and public disclosure of the rate at which patients end up back in the hospital for the same problem after being discharged.  Poor performing hospitals will be required to work with Patient Safety Organizations (PSOs) to improve their performance with the goal of improving overall patient care and reducing costs.
  • Shared Decision Making (SDM).   Shared Decision Making is used in situations where there are multiple treatment options with a similar level of effectiveness.  SDM works by providing the patient with an aid that includes information (often by video) about their options along with a decision-making tool (often a written survey form) and counseling to assist the patient to make the best treatment decision for them based on their condition and values.For example, lower back pain responds similarly to therapy and surgery.  A patient decision aid would inform a patient of the facts and help the patient decide, along with counseling, which treatment is best for him or her. 

    Section 217 which Senator Gregg developed with Senators Kennedy and Mikulski provides for the development of standards for patient decision aids and a process for the certification of those aids to ensure the products are fair and unbiased.  It also provides grants to develop, update, produce and test patient decision aids.

    The Dartmouth Institute for Health Policy and Clinical Practice has found that the use of this technique enhances patient satisfaction while also reducing costs as patients opt for less invasive options once they have complete information.

  • CLASS Act.  Senator Gregg was also successful in including language in the bill to require that a new entitlement program for community-based long term care be actuarially sound. The original language in the bill set the premiums for the program at a very low level that would have made it totally insolvent and an additional burden on taxpayers.  One outside actuarial analysis found that the program, as originally drafted, would have been as much as $2 trillion underfunded.

    To fix this problem, the Gregg amendment eliminated the artificially low premium and will require the Secretary of Health and Human Services to determine premiums based on a long term actuarial analysis of the program. 

  • Expanding Incentives for Prevention and Wellness Programs: The Safeway model.  A significant portion of health care costs in the United States can be linked to individual behavior and personal choice.  Currently, financial incentives that employers may provide their employees for enrolling in wellness programs that are designed to improve personal health are capped at 20 percent of the cost of employee-only coverage.In order to provide employers with the opportunity to further develop and incentivize programs that improve the health of employees and their families, Senator Gregg worked to craft a bipartisan amendment that will increase the cap to 30 percent of the cost of employee-only coverage, with the option for the Secretary of Health and Human Services to further expand the cap to 50 percent.  This action will give employers more flexibility to motivate employees to take advantage of wellness programs that assist them in making improvements to their own, and their family’s overall health.
  • Tom DeRosa

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    2 Responses to “Sen. Gregg on Health Care”

    1. Author

      [...] Read the original post: Sen. Gregg on Health Care [...]

    2. Author

      When did we EVER get the idea that hospitals and doctors should treat people for FREE?

      We do NOT need health insurance for everyone; we need a sense of RESPONSIBILITY.

      If you are treated at a Hospital and can’t pay, you WORK for the Hospital either full time (if you do not have a job) or part time (if you have a job that does not offer health insurance). Anyone can mow a lawn, answer a phone, paint a wall, mop a floor or empty a bed pan. This lowers the cost of hospital maintenance (since they do not have to hire someone to do these jobs) and repays a part of the person’s debt over time. This also gives the person a sense of responsibility and dignity.

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