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 Wednesday, September 2, 2009 |
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Flu could sicken lucrative hospital revenue
A severe outbreak of the swine flu could cost hospitals key sources of revenue, a government report said last month. Hospitals might be forced to allocate beds to flu patients that otherwise would be available for elective surgeries and other revenue-producing activities, said the report on the H1N1 influenza by the President's Council of Advisors on Science and Technology. As many as 300,000 of the potential 1.8 million hospital admissions could end up in intensive-care units, swamping the systems. 
Q&A
 Health care reform has been on the mind of Eric R. Wright, director of the Indiana University Center for Health Policy and associate dean of IU's School of Public and Environmental Affairs at IUPUI.
Q: Are you surprised at the level of opposition to the health care reform proposals?
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A: I am not surprised about the way the debate has unfolded. I believe the initial enthusiasm for health reform reflected the vast majority of Americans' views that our health care system is broken and in dire need of a major overhaul. Most people today - consumers, business leaders, health care providers and policymakers - are deeply concerned about the rising cost of health care and questioning whether we are getting our money's worth.
In the debate over health reform, like most other major policy debates, the devil is in the details. As the specifics of the various proposals have come into clearer focus over the course of the summer, the deliberations have, not surprisingly, only intensified.
The passion that people bring to this debate reflects deep divisions about core values and beliefs. At the same time, the debate has rallied a myriad of interest groups and advocacy groups that have a financial or political stake in how we decide to reform the health care system.
Q: What aspects of the current debate are you most concerned about?
A: I am very concerned about the quality of the debate and discussion. Much of the rhetoric is simply preying on people's natural fears of change rather than helping them truly understand the issues. Even for those of us who have the time and training in policy analysis, it is difficult to fully appreciate the details of the proposals.
The problems in our health care system are incredibly complex, and fixing them will inevitably require complex, carefully crafted reform strategies. We should be more skeptical and ask hard questions of advocates and so-called experts who simply call for "more competition," who warn against "socialized medicine" and a "government takeover" of health care, or who argue that "price transparency" and more "consumer responsibility" alone will redress health care market inefficiencies.
Catchphrases like these do little to educate people about the relative strengths and weaknesses of particular reform recommendations. Unfortunately, the recent inflammatory rhetoric is shaping public opinion. But recent surveys also suggest that public interest in the debate remains strong. People are interested in learning more about the details of the various proposals.
Each of us can help us in making this a more productive public discussion if we encourage everyone to tone down the rhetoric, ask more challenging questions, listen more carefully, and reflect on what we learn before drawing any conclusions about any particular health reform strategy.
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Q: What's the harm if some sort of fundamental reform is not enacted?
A: From a historical perspective, major policy debates come in waves, and political opportunities to fix our health care system have been few and far apart. The last time we had a window of opportunity for major health reform was under President Clinton in 1992-1993. Over the past four decades, when it comes to health policy, we have been content to simply tinker in different sectors of our health care system and avoided more comprehensive reform.
Our more cautious, incremental approach to health reform, unfortunately, has failed to bring about the fundamental restructuring of the system that most health policy experts agree is critically needed. If Congress and the president fail to enact reform this year, it will probably take several years to rebuild the political momentum necessary to re-engage the public and policymakers in this crucial conversation. |
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Ultimately, I believe the real risk we face is that we will delay taking bolder steps and do nothing. We know that people who have no health insurance often delay getting treatment, waiting instead until they are either so sick or in such horrible pain that they just can't take it anymore. When they do go to the doctor, the treatment prescribed is invariably much more expensive, more invasive and painful, and ultimately less effective in restoring the person's health and quality of life. I fear the same may be true with reform.
Survey: White House reform unconvincing
A survey designed and funded by two Indiana University health organizations found that most Americans believe what the Obama administration deems to be myths about proposed health care reform plans.
Ironically, says Aaron Carroll, director of the Center for Health Policy and Professionalism Research, the least-believed "myths," such as those related to mandatory end-of-life and euthanasia counseling, "are those that have gained the most traction in the media and have resulted in changes to the House of Representatives bill.
Only three in 10 surveyed said they believe the government will require the elderly to make decisions about how and when they will die, despite considerable media attention on the topic.
While proposed legislation would require that Medicare pay for voluntary counseling sessions about end-of-life care, it would not require doctors to counsel patients to refuse medical intervention, according to the Annenberg Public Policy Center.
The Aug. 14-18 survey of 600 people in 48 states was conducted by Market Strategies International for the center and the IU Center for Bioethics.
The survey found that 67 percent of respondents believe that wait times for surgery and other health care services would increase. Six in 10 thought taxpayers would be required to pay for abortions. And 46 percent believed proposed legislation would result in health care for illegal aliens.
Regarding those issues, an Annenberg analysis of legislation said illegal immigrants would not be entitled to care. But it appears public money would be available for abortion through a public health plan.
Only 29 percent believed that private insurance coverage would be eliminated and 36 percent believed that private insurers would be put out of business if a public insurance option were passed.
According to Annenberg, private insurance would not be disallowed, but some employees could lose their current plans to the extent that an employer decides to drop an existing plan for another - or leaves it up to workers to purchase their own private plan or opt for a government plan.
While not surprising that more Republicans tend to believe certain things than Democrats, Carroll said, what is surprising is "just how many Republicans - and independents - believe them."
"If the White House hopes to convince the majority of Americans that they are misinformed about health care reform, there is much work to be done," IU's Carroll added.
Company news
Indianapolis-based Fairbanks Institute has tapped a Beltsville, Md., firm to process biological samples for the second phase of its Indiana Health Study, involving type 2 diabetes. BioServe also won work on an earlier phase of the study.
General BioTechnology of Indianapolis has received a $350,000 Small Business Innovation Research grant from the state to further develop its Advanced CryoTechnology Cell Washing Device. The device, which has received about $1 million in federal funding, pumps bone-marrow stem cells through a fiber-filled tube that filters out dimethyl sulfoxide. The bone-marrow preservative can cause complications for patients.
People
 Sandi Huddleston has been elected as the first woman to lead Johnson Memorial Hospital's board of trustees. Huddleston, executive director of Excellence in Public Service Inc., succeeds Greenwood attorney Jon Williams. Michael Pauszek was named vice chairperson and Martin Umbarger was elected board secretary.
Erika Cottrell has established a practice at the Franciscan Spine Center at St. Francis Hospital and Health Centers. The graduate of the Indiana University School of Medicine previously worked at Integra Healthcare, where she was a staff physiatrist.
Compiled by Chris O'Malley comalley@ibj.com
Edited by Norm Heikens
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