Page 31 - Modern Healthcare (January 2020)

Achieving significant healthcare reform requires
a congressionally mandated commission
By Randy Oostra
s CEO of ProMedica, an Ohio-based integrated healthcare network, it is
beyond disturbing whenever I read about more research demonstrating that
A Americans comparatively live shorter lives and experience more disease—
despite our spending vastly more for healthcare than any other country.
We desperately need healthcare ex- Randy Oostra sum, improve population health, re-
ecutives to step up and lead a wholesale is president and duce spending growth and address the
redesign of how care is delivered and CEO of Toledo, social factors that increasingly are un-
paid for in this country. Ohio-based derstood as major factors in affecting
As readers are likely aware, for the first ProMedica. health outcomes.
time in 100 years life expectancy has de- It is currently our view that such a
clined for three consecutive years. The commission would need to address five
number of non-elderly uninsured has principles: healthcare coverage must
been increasing since 2017 and is now be universal and affordable; emphasis
nearly 30 million. Nearly half of those must be placed on primary care, behav-
insured are underinsured, the same per- The evidence dictates an urgent need ioral health and healthy aging; social
centage as before passage of the Afford- for major healthcare reform. service supports need to be integrated;
able Care Act. A widely reported 2018 Over the past year, representatives healthcare spending must be made ef-
Federal Reserve poll found 40% of adults from ProMedica and several other ficient, meaning of increasingly higher
could not afford an unexpected expense healthcare networks throughout the value, measured as outcomes achieved
of $400. A more recent Gallup poll found country have held preliminary meetings relative to spending; and finally, but by
that 13% of adults, or 34 million Ameri- with germane congressional commit- no means least, the healthcare work-
cans, admitted knowing someone who tees and leadership offices advocating force must meet the demand for ser-
died because they could not afford nec- for a congressionally mandated national vices, especially in serving care needs in
essary medical care. healthcare commission. rural areas and in behavioral health.
Healthcare spending, currently at There are numerous examples of We will continue to meet with con-
more than $3.6 trillion, is projected to congressionally created commissions. gressional staff through this session.
reach $6 trillion by 2027, or one year af- A November report from the Congres- Our hope is that leaders independent
ter bankrupting the Medicare trust fund. sional Research Service identified well of party affiliation will appreciate—for
Nearly $1 trillion of that spending is con- over 100 established since 1989, includ- at least three reasons—the importance
sidered waste. (See related story, p. 18.) ing the 1997 National Bipartisan Com- of, and the necessity for, a healthcare
Pay-for-performance models, such as mission on the Future of Medicare, reform commission: The failure to pass
accountable care organizations and bun- which helped lead to passage of Medi- surprise-billing legislation in 2019 again
dled-payment arrangements, have yet to care Part D legislation in 2003. While demonstrates Congress’ difficulty in
come close to bending the cost curve. commissions have had mixed success, setting aside partisanship; polling data
We continue to measure quality with- the stakes have never been higher. We show healthcare is the most import-
out accounting for value or outcomes see no alternative. ant issue voters take into consideration
relative to spending. Social service when evaluating 2020 candidates; and,
supports remain largely unaddressed. A commission—preferably time-lim- as genuine and passionate as Medicare
Healthcare disparities continue to per- ited and comprised of bipartisan ex- for All campaign pledges are, successful-
sist. All this and more leaves physicians perts representing the diversity of ly legislated healthcare reform should be
and other clinicians with unprecedented healthcare and social service provid- methodically examined.
rates of burnout, major depressive disor- ers—would make policy recommen- We invite your participation in joining
der and unacceptable rates of suicide. dations to Congress that would, in us in this effort. If not now, when? l

January 27, 2020 | Modern Healthcare 27