Wednesday, December 16, 2009

Health care reform at a critical juncture

Discussions on health care reform continue in the Senate, which may be on target to meet its self-imposed deadline of passing a bill by Christmas. Of course this will not be the last word—the Senate bill and House bills must be reconciled before a final bill reaches the President’s desk, so a definite picture of a final bill is still a ways off.

However, a recent Washington Post-ABC News poll found that Americans are cooling to health care reform as the debate continues to drag on. The poll found that just 37 percent of those polled believed that the quality of their care would be better under a new system constructed by reform, while 50 percent see it as better under the current set up.

I find this dichotomy interesting. I know without a doubt that miracle moments occur in our U.S. health care facilities every day. However, it is widely reported that the American health care system falls behind the health systems in other developed nations. The Commonwealth Fund’s 2007 report, Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, reported that the U.S. health care system ranked “last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives” when compared with five other nations (Australia, Canada, Germany, New Zealand and the United Kingdom ).

However, the attempt to reform the health care delivery system in the U.S. can never be a discussion solely about costs or benefits or insurance plans. Those things are all important discussions to have, but they are not the most critical. This is why I have said from the beginning that those in our country who are having discussions about the shape and direction of reform should have them around a table with a picture of a patient and his or her family in the center. It is imperative that we remember that health care reform—just like health care delivery—is about people and their lives.

Ezra Klein, a blogger for The Washington Post, reminds us that we may want to start referring to these bills a “150,000-plus-life health care plan,” as he calculates that, based on the Institute of Medicine and Urban Institute’s data, this is the number of lives lost due to lack of insurance over 10 years.

The bills under consideration by Congress may not be perfect, and may have to be re-examined in 8 to 10 years. However, the process of moving toward accessible care for all Americans is an important one, which is why CHRISTUS continues to do our best to stay involved.

CHRISTUS’ Journey to Excellence and experience providing care for all those who need it, regardless of their ability to pay, positions us well to understand the far-reaching impacts of reform. CHRISTUS operates in some of the states with the highest uninsured numbers in the country, and has been forced to create more effective ways to provide care within the structures that exist in the very different states and even countries where we operate, aiming to become the low cost, high quality provider in each of our markets.

So we continue to work to tell our story. Because it is CHRISTUS Health’s mission to extend the healing ministry of Jesus Christ, we are called to support the life and dignity of every person from conception to natural death. Consequently, we are committed to bringing swift fundamental change to the health care system of the United States.

In regard to the Senate legislation, we are supportive of the principles articulated by the Catholic Health Association and broader reform measures articulated by the Bishop’s Conference in their document entitled, A Framework for Comprehensive Health Care Reform. In addition to these, we support the following principles, which we believe are embraced by the Senate bill:

• Oversight: Health providers must be accountable for demonstrating that the care they provide is high quality and cost-effective. We believe that reimbursement systems should reward quality, not quantity, of care.
• Standardization and Collaboration: CHRISTUS supports efforts to reduce barriers among all health care providers so that standardization exists in the provision of care and to ensure that care is better coordinated among providers.
• Workforce Initiatives: An expansion of health coverage must address the need for a workforce to meet the primary care needs of a population that previously could or did not access preventive care.
• Future Planning: A bill crafted now may fit the country’s needs for approximately the next several years, but given the advances we expect to see in medicine, science and technology, it may not be sufficient for the future. . Therefore we must anticipate revisiting health care reform in the future. Your legislation should include language which easily facilitates and anticipates needed changes and adaptations.
• Cost and Coverage: CHRISTUS agrees with Congress’ call on employers, individuals, unions, suppliers, insurers and other providers to do their part to contribute to health reform so that premium subsidies will put coverage within reach of those who could not otherwise afford it. We also support current advocacy efforts to provide additional subsidies to those with incomes from 133 to 150 percent of the federal poverty level, as well as to increase the number of people with health care coverage and/or scale back the proposed reductions in Medicare and Medicaid disproportionate share hospital funding (DSH).

Let there be no uncertainty – CHRISTUS supports health reform as the ultimate issue for promoting the health and well-being of our nation and those that reside here. It is morally and ethically right, and it is good for our economy and national security.

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