Emergency Visits Are Increasing, New ACEP Poll Finds; Many Patients Referred By Primary Care Doctors

/PRNewswire/ -- More than 80 percent of emergency physicians responding to an ACEP poll said emergency visits are increasing in their emergency departments, with half reporting significant rises, and more than 90 percent expecting increases in the next year. Almost all (97 percent) reported treating patients on a daily basis who were referred to them by primary care doctors, going against a widely-held assumption that people are choosing to go to the emergency department instead of seeking primary care.

At the same time, 97 percent of emergency physicians also report treating Medicaid patients on a daily basis who could not find any other doctor to accept their health insurance. If the new health care reform legislation provides insurance coverage that reimburses doctors at Medicaid rates, this could exacerbate a lack of access to medical care.

"This poll confirms what we are witnessing in Massachusetts — that visits to emergency rooms are going to increase across the country, despite health care reform, and that health insurance coverage does not guarantee access to medical care," said Dr. Sandra Schneider, president of the American College of Emergency Physicians. "Emergency medicine provides lifesaving and critical care to millions of patients each year and yet only represents 2 percent of the nation's health care expenditures. Emergency physicians command the resources of a hospital to provide the best care for patients, but we must be prepared for increasing numbers of patients, not fewer, especially given our growing elderly population."

ACEP conducted the poll from March 3 to March 11, 2011. E-mails were sent to 20,687 emergency physicians, and 1,768 responded. The survey has a theoretical sampling error range of plus/minus 2.23.

While 79 percent of responding emergency physicians said their emergency departments use resources efficiently, nearly half of respondents (44 percent) said the fear of lawsuits was the biggest challenge to cutting emergency department costs. More than half (53 percent) of emergency physicians reported that fear of lawsuits is the main reason for ordering the number of tests they do.

"Emergency departments need more resources, not fewer, and medical liability reform would help reduce overall costs by reducing the need for defensive medicine," said Dr. Schneider.

Two-thirds of emergency visits occur after business hours, when doctor's offices are closed and patients have nowhere else to turn. Visits to ERs reached an all-time high of nearly 124 million in 2008, according to the Centers for Disease Control and Prevention (CDC) and are expected to rise nationwide.

Physicians responding to the poll attribute the overall increase in emergency patients to patients without health coverage (28 percent) and a growing elderly population (23 percent) are seen by physicians as the most important reasons for the overall increase in ER patients.

An overwhelming 89 percent of physicians believe the number of visits to the emergency department will increase as health care reforms are implemented with 54 percent of them expecting to see a significant increase.

"Emergency visits have increased at twice the rate of the U.S. population, and less than 8 percent of those patients have nonurgent medical conditions, meaning the vast majority need to be there," said Dr. Schneider. "At the same time, hundreds of emergency departments have closed. The new health care reform law does not address these problems and with the elderly population and more emergency departments forced to shut down, this crisis will only get worse."

More than 1,400 (82.5 percent) responding to the poll said that lives were saved every day in their emergency departments. "Emergency medicine is critical at any hour of the day. It must be there when you need it," said Dr. Schneider.

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HHS awards $130 million to boost health professions workforce

Georgia to receive over $2.6 million in grants

HHS Secretary Kathleen Sebelius today announced $130.8 million in grants to strengthen and expand the health professions workforce. Six areas are targeted: primary care workforce training, oral health workforce training, equipment to enhance training across the health professions, loan repayments for health professionals, health careers opportunity programs for disadvantaged students, and patient navigator outreach and chronic disease prevention in health disparity populations. The grants include $88.7 million in funding from the American Recovery and Reinvestment Act of 2009.

"An adequate health care workforce is the linchpin for reforming our health care system to ensure greater access, improve the quality of health care and cut overall costs in the long term," said Secretary Sebelius. "Today's awards not only will provide more training opportunities for people interested in a health professions career, but also will support equipment purchases and faculty development to expand and enhance the quality of training."

"With an aging and increasingly diverse population, we need to prepare our health professionals to meet the challenges of providing health care in the twenty-first century," noted Mary K. Wakefield, Ph.D., R.N., administrator of HHS' Health Resources and Services Administration (HRSA), which oversees the programs. "This includes ensuring diversity in the workforce, and that well-trained professionals practice in areas of severe need."

Expanding the Primary Care Workforce

Training Programs in Primary Care - $42.1 million ($31.5 million Recovery Act)
Grants will support family medicine, general internal medicine, and general pediatrics programs, including curriculum development, faculty development, didactic and community-based education, and training in underserved areas for primary care residents, pre-doctoral students, interdisciplinary and inter-professional graduate students, and physician assistant students.

Oral Health - $23.9 million ($6.7 million Recovery Act)
Funding will target workforce development programs for pre- and post-doctoral training for dental residents; dental faculty; loan repayment for faculty who teach primary care dentistry; and training for practicing dentists, or other approved dental trainees in general, pediatric, and public health dentistry and dental hygiene programs. Funding also includes $4.3 million to states to provide 9 new grantees the opportunity to address their states' unique oral health workforce needs in underserved urban and rural areas. Grants are designed to strengthen the delivery of multidisciplinary comprehensive oral health care, integral to quality primary care.

Equipment for State-of-the-Art Learning

Equipment to Enhance Training for Health Professionals - $50.5 million (Recovery Act)
Funding from the Recovery Act will provide 208 awards to assist with purchasing equipment for training current and future health professionals across disciplines at the undergraduate, graduate, and post- graduate education levels. Awardees include academic health centers, area health education centers, centers of excellence, and other educational institutions that serve underserved and uninsured patient populations, rural communities, and minorities. Equipment purchases will expand current training capabilities by replacing outdated equipment and technology or purchasing equipment that previously was unaffordable.

Types of equipment to be purchased include e-learning tools such as video, audio and interactive learning systems that provide more distance learning opportunities; human patient simulators that give students the opportunity to improve clinical judgment and critical thinking; and mobile dental vans that provide training in delivering care to diverse segments of the population while bringing basic routine dental treatments to families unable to access care. It is estimated that more than 200,000 individuals will be trained, including health professions students, faculty and clinical practice providers.

Priming the Workforce Pipeline

Loan Repayment ($8.3 million) - 29 grants will be made to states that provide matching funds to assist health professionals in repaying their educational loans. In return, these individuals agree to provide full-time primary health services in federal health professional shortage areas for a minimum of two years. Health professionals eligible to receive funding include physicians, dentists, nurse practitioners, nurse midwives, physician assistants, psychologists, and social workers.

Health Careers Opportunity Program ($2.1 million) - Three grantees will receive funding to increase diversity in the health professions by developing an educational pipeline to enhance the academic performance of economically and educationally disadvantaged students, and prepare them for careers in the health professions. Eligible applicants included schools of medicine, public health, dentistry, pharmacy, allied health, and graduate programs in behavioral or mental health.

Patient Navigator ($3.8 million) - Funding will support 10 grants for patient navigator outreach and chronic disease prevention programs to develop and operate patient navigator services that improve health care outcomes for individuals with cancer or other chronic diseases, with specific emphasis on health disparity populations. Grant recipients recruit, train, and employ patient navigators with direct knowledge of the communities they serve to coordinate care for patients with chronic illnesses. Eligible applicants include federally qualified health centers, health facilities operated through Indian Health Service contracts, hospitals, rural health clinics, and academic health centers.

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HHS Secretary Kathleen Sebelius and Other Health Experts to Host Webchat on Health Insurance Reform and Seniors

U.S. Department of Health and Human Services Secretary Kathleen Sebelius and Assistant Secretary for the Administration on Aging Kathy Greenlee will host a webchat today, THURSDAY April 8, to
discuss the benefits of the new health reform law as it relates to America's seniors. Sebelius and Greenlee will highlight some of the immediate benefits of health reform for America's seniors before
answering pre-submitted questions from the public.

The chat is the second in a series of discussions that is designed to help Americans understand the benefits of the newly passed health insurance reform law.

Members of the public are encouraged to submit questions via email to HealthReform@hhs.gov. HHS officials will try to answer as many questions as possible during the web chat and post up questions and answers on the web site as well.

WHAT: Health Reform Weekly Webchat with HHS Secretary Kathleen Sebelius, Assistant Secretary for Aging Kathy Greenlee and Principal Deputy Administrator for the Centers for Medicare & Medicaid Services, Marilyn Tavenner

WHEN: Thursday April 8, 2010 at 1:00 p.m. EDT

WHERE: www.HealthReform.gov

The webchat will be available via satellite feed at the following coordinates:

SATELLITE:
G-19 04K Digital Only Slot B
Orbital Location: 97' West

Ku-Band
D/L: 11786.4Mhz Horizontal
FEC: 3/4
Symbol Rate: 6.111319 @ 204 packet = 8.448 Data Rate
4X3 Aspect Ratio


For more information on the new health reform law please visit www.healthreform.gov

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New Study Shows That American Public is Willing to Accept Major Reforms in Medicare Program

/PRNewswire/ -- Although Americans see Medicare as a key part of the country's social contract and want to preserve it in some recognizable form, they are willing to consider significant changes in the program to hold down its costs as the U.S. population ages.

In day-long "Choice-Dialogues" in which Americans from all walks of life considered the pros and cons of a range of choices for reforming Medicare, common ground was found in several key areas:

-- Allow Medicare to negotiate prices for prescription drugs (94 percent
support).
-- Encourage hospice care instead of heroic end-of-life measures (85
percent support).
-- Only cover treatments that are scientifically proven to be effective
(68 percent support).
-- Emphasize preventive care and personal responsibility (89 percent
consider preventive care very important or essential).
-- Gradually increase the Medicare eligibility age from 65 to 67 (68
percent support).


If additional money is needed to maintain Medicare in a way that is familiar in the future, Americans would rather see the government raise taxes than increase the federal debt.

These are among the central findings in a report released today by The Concord Coalition and Viewpoint Learning, Inc. The report is entitled "Medicare: It's Not Just Another Program."

The report, which was written by Viewpoint Learning, also underscores public dismay at the health care system in general. It comes as Congress and the Obama administration are working on massive changes in the entire system.

"Participants repeatedly expressed concerns over what they saw as a Byzantine and unaccountable health care system," the Medicare report says. "Most felt that the medical industry (especially the pharmaceutical companies) puts profits before people."

Robert L. Bixby, executive director of The Concord Coalition, says the report shows that Americans are prepared to accept significant changes in the program that plays a central role in the federal government's long-term fiscal problems.

"Medicare is on an unsustainable path and must be reformed," Bixby said. "According to conventional wisdom, however, the public is not ready to accept any change in the status quo. The good news from these Choice-Dialogues is that the conventional wisdom is wrong; the public is ready and willing to consider some very fundamental Medicare reforms so long as the program is preserved as a vital part of the social contract."

"Politicians who are truly interested in saving Medicare should stop the scare tactics and start engaging the public in a dialogue on the real trade-offs that must be confronted," Bixby added. "Changes will still be difficult, but the results will be more acceptable."

Viewpoint Learning conducted the dialogues with randomly selected representative samples of 35-40 citizens in Oak Brook, Illinois; Columbia Maryland; Phoenix and Houston. This project builds on the findings of a broader two-year project, "The America We Want," that examined public opinion on a broader range of federal programs and budget issues.

The new report found that many Americans lacked a strong understanding of the Medicare program, how it is funded, and the severity of the fiscal challenges facing the United States in the years ahead.

Yet most participants in the dialogues, after studying these issues in depth and spending much of a day discussing the problems and possible solutions with others, were able to agree on a set of Medicare changes.

But to win public support, the report cautions, "proposals for major reform to Medicare need to recognize the extent to which Americans see Medicare as an essential part of the social contract and not just as another government program."

Steven Rosell, president of Viewpoint Learning, said "The findings from these daylong dialogues with Americans from very different backgrounds and perspectives reveal deep disconnects between how Washington talks about Medicare and health care reform and how the public talks about them. In case after case, the report shows how leaders and the public are talking past each other, and how this deep disconnect and misunderstanding lead to the heat and the rancor that have made advancing real reform so difficult."

When most people talk about the "cost of health care," for example, they are focused on what they pay in premiums, co-pays and drug expenses. When health care experts talk about costs, however, they usually focus on the costs to businesses, government and other institutions.

Rosell also noted that many Americans do not realize that they are essentially paying for the cost of care for the uninsured already.

The new report, he said, provides insight for leaders about how best to bridge such disconnects and begin to create a learning curve that could lead to public support for significant Medicare reform.

Some elements in the new report also echo the findings of The Concord Coalition's fiscal advisory councils that met in early December in Washington. Working in six different parts of the country on Concord's Fiscal Stewardship Project, these advisory councils called for sweeping reforms in the health care system and some changes in Medicare to put the government on a more sustainable fiscal path. More information on the advisory councils' work is available at:

http://concordcoalition.org/fiscal-stewardship-project/fiscal-stewardship- project.

The full report, entitled "Medicare: It's Not Just Another Program," is available at: http://www.concordcoalition.org/files/uploaded-pdfs/Medicare_Report_Dec09_PRIN T.pdf

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Healthcare Bills Will Hamper Medicare Services for Seniors and the Disabled

/PRNewswire/ -- The following is news about the Medicare power mobility benefit from Support Mobility Now Volume 1 Issue 2:

Significant changes are needed in healthcare reform legislation to prevent senior citizens and the disabled from facing a difficult time obtaining homecare products through Medicare. The current legislation would likely prevent or delay many Medicare beneficiaries from receiving critical medical equipment that helps sustain their lives and allows them to live independently in their homes for longer periods of time.

Unfortunately, in piecing this historic legislation together, lawmakers may have overlooked the fact that some of the changes for medical equipment providers would adversely impact their ability to deliver timely and quality service to Medicare beneficiaries.

To be sure, America's healthcare system must be improved. But there should also be a responsibility to ensure that the changes don't place additional burdens upon Medicare beneficiaries, who are already some of the most vulnerable men and women in our society.

Medicare's power mobility benefit would be hit especially hard.

Currently, Medicare allows a beneficiary to purchase power wheelchair in the first month it is prescribed or rent the equipment for 13 months. The legislation eliminates a beneficiary's early purchase option. Seniors and people living with disabilities, who qualify for power wheelchairs, usually suffer from long-term, chronic conditions so they overwhelming chose the early purchase. Without the first month purchases, providers say they won't have the cash flow to pay the wheelchair manufacturers or provide other services required. Many equipment suppliers anticipate that they may go out of business or no longer offer power wheelchairs, a development that would make it more difficult for beneficiaries to find providers in their area.

Some in Congress recognize the potential danger from ending the early purchase.

Pennsylvania Sen. Arlen Specter proposed an amendment to preserve the first-month purchase option while obligating suppliers to pay back Medicare when equipment isn't used full term. The Congress, however, quickly showed how much financial concerns are out weighing practical ones: The Specter amendment essentially died when the Congressional Budget Office (CBO) contended that only $200 million would be saved over 10 years with his proposal, while lawmakers sought $800 million in savings. The industry maintains that the CBO was wrong, and that much more than $200 million would be saved with Specter's amendment.

Aware that the Congress is fixated on finding savings to pay for healthcare reform, providers are willing to accept further, yet agonizing, reductions in the reimbursement rates for power wheelchairs in exchange for keeping the purchase option and sustaining a process that would at least allow companies to stay in business.

The Senate legislation also accelerates the implementation of the competitive bidding program for Durable Medical Equipment (DME), which includes oxygen, power wheelchairs and other homecare products. Competitive bidding for these products was first implemented last year, but the program was flawed to the point that patients' lives were endangered because of confusion and delays in getting life-sustaining equipment to beneficiaries, hospitals and other institutions. Congress stepped in, and temporarily halted the program in July 2008. The Centers for Medicare and Medicaid Services (CMS) has re-launched the bidding program, but providers say that many of the original problems have not been corrected. The healthcare reform legislation makes matters worse by ordering a rapid expansion of the competitive bidding process before stakeholders can gauge whether the program can avoid putting some of the most vulnerable people in our society at risk.

Once again, some lawmakers recognize that the rush to pay for healthcare reform legislation could have a devastating impact on their constituents. Competitive bidding is projected to save millions of dollars. But Florida Rep. Kendrick Meek is more concerned about his constituents: he has sponsored legislation in the House that would end the competitive bidding experiment and obtain savings for the government by cutting the reimbursement rate for homecare products by 0.25% from 2010 to 2012 and an additional 0.5% in 2015. Moreover, the industry wants to work with CMS to establish a system that allows providers to deliver quality service and products to Medicare beneficiaries at a fair price to the government.

Comprehensive healthcare reform is long overdue, but we must ask our Representatives and Senators in Congress whether the cost of enacting this legislation should include placing new burdens on seniors and people with disabilities. One would hope that this population would benefit from reform, and not be its victims. It's clear that the current legislation delivers critical blows to the companies committed to providing medical equipment to Medicare beneficiaries.

What's unclear is whether enough lawmakers in Congress will recognize the consequences for their constituents back home when there are significant delays in providing medical equipment for Medicare beneficiaries, or only a few companies left to supply the products. There are ways to fix healthcare reform legislation so that the seniors, who built and protected our nation, can live with dignity and independence in their homes during their twilight years.

Let's hope Congress understands how much this means to them.

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Health Reform Needs Enforceable National Workforce Strategy

/PRNewswire/ -- Congressional leaders must ensure that health reform includes a health workforce planning body with sufficient authority to ensure implementation of an integrated, coordinated national health workforce policy, according to Dr. Steven A Wartman, president and CEO of the Association of Academic Health Centers (AAHC). "With each step in the legislative process, the Congress has progressed toward a more effective health workforce planning process," Wartman said. "Still missing from both House and Senate bills is a mechanism -- such as national health workforce commission recommendations that automatically go into effect unless overridden by Congress -- to ensure timely implementation of the recommendations," added Wartman, urging Congress to address this concern before finalizing the legislation.

An updated analysis of the current House and Senate bills released today by the AAHC identifies additional strengths and weaknesses in the bills when measured against the AAHC's own health workforce recommendations:

-- The AAHC recommends that development and implementation of an
integrated, coordinated, strategic national health workforce policy be
the primary objective of any advisory committee or national
commission. The House bill contains a clear statement that the
purpose of its advisory committee is "to develop and implement an
integrated, coordinated, and strategic national health workforce
policy reflective of current and evolving health workforce needs,"
while the Senate bill only lists national health workforce policy as
one of several priorities.
-- The AAHC recommends the list of enumerated issues to be addressed by
the advisory committee or national commission include the
harmonization of conflicting national and state-based regulatory and
private self-regulatory standards (e.g., licensure, scope of practice,
accreditation). The Senate bill expressly directs its national
commission to "identify barriers to improved coordination at the
Federal, State, and local levels," but the House bill does not
expressly address the need for harmonization.
-- The AAHC recommends the creation of a permanent, independent advisory
committee or national commission that serves as a continuously
available policy research and consultative resource. The Senate bill
creates an independent national commission composed of members
appointed by the Comptroller General, while the House bill only
creates an advisory committee appointed by and reporting through the
Secretary.

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New National Poll Finds Americans Strongly Opposed to Cutting Medicare Payments for Nursing Home Care as a Means of Financing Health Care Reform

/PRNewswire/ -- As federal lawmakers continue to sound out constituents over the August recess on health care reform, and how best to finance a broad-based overhaul, a new Mellman Group (D) national survey (1000 Registered Voters, 8/21-24, +/- 3%) finds Americans, by significant margins, strongly oppose cutting Medicare-funded nursing home care over other funding options. Underscoring the unpopularity of cutting Medicare-financed nursing home care - now proposed by Congress - the data finds a full 66% of voters less likely to support their local member of Congress for reelection if they voted to cut seniors' Medicare-funded care to finance health care reform, believing that cutting such payments would reduce quality of care.

Says the new Mellman Group poll analysis:

"Voters overwhelmingly oppose cutting Medicare payments to nursing homes as a means of financing healthcare reform, expressing their distaste for this approach in several ways during our brief survey.

First, it is the least popular of the funding options being considered.

Second, cutting Medicare payments to nursing homes is far and away the least acceptable method of financing reform.

Finally, a large majority of voters would feel less favorable toward a Member of Congress who supported such an approach. Voters say they will take out their anger on Members who vote for such nursing home cuts at the ballot box. The reason is straightforward--most Americans believe that cutting such payments will reduce the quality of care seniors receive in nursing homes. While healthcare reform is important to many Americans, Medicare funds for nursing homes are considered off limits as a way to finance reform."

When asked "If Congress cut $32 billion in Medicare payments to nursing homes to care for seniors, do you think the quality of care seniors receive in nursing homes would get better, stay about the same or get worse?" the analysis indicates that, "Seniors are equally concerned, as 78% of those over 65 believe nursing home care will get worse because of such cuts and a majority believe care will get much worse (58%)."

The following are the poll questions and results:

1. Congress is now considering ways to pay for healthcare reform. Which one of the following do you think is the most acceptable way to pay for healthcare reform?

Cutting Medicare payments to nursing homes to care for seniors 3%
Raising taxes on people who make over $250,000 per year 45%

Requiring people to pay taxes on generous healthcare benefits they receive from their employers 6%

Taxing health insurance companies 14%
None 26%
Don't know 6%


2. And which one of the following do you think is the least acceptable way to pay for healthcare reform?

Cutting Medicare payments to nursing homes to care for seniors 49%
Raising taxes on people who make over $250,000 per year 8%

Requiring people to pay taxes on generous healthcare benefits they receive from their employers 14%

Taxing health insurance companies 9%
None 14%
Don't know 6%


3. If Congress cut $32 billion in Medicare payments to nursing homes to care for seniors, do you think the quality of care seniors receive in nursing homes would get better, stay about the same or get worse? [IF BETTER/WORSE ASK]. And is that much [BETTER/WORSE] or only somewhat [BETTER/WORSE]?

Much better 4% 7%
Somewhat better 3%
Stay about the same 11%
Somewhat worse 19%
Much worse 59% 78%
Don't know 4%


4. If your Member of Congress voted to fund healthcare reform in part by cutting $32 billion in Medicare payments to nursing homes to care for seniors would you be __more likely to vote to reelect them, __less likely to vote to reelect them or would it not make much difference to your vote? [IF MORE/ LESS LIKELY ASK:] Is that much [MORE/LESS] or somewhat [MORE/LESS] likely?

Much more likely 5% 7%
Somewhat more likely 2%
No difference 20%
Somewhat less likely 17%
Much less likely 49% 66%
Don't know 6%


"From the results of this objective, timely and highly significant national survey, it is abundantly clear the public, to its credit, harbors strong antipathy to slashing Medicare beneficiaries' nursing home benefits to finance any broader reform package," stated Bruce Yarwood, President and CEO of AHCA. "We strongly support the laudable objective of the Obama Administration and Congress to expand Americans' access to care, and help bring down health care costs. However, we will continue to warn both on Capitol Hill and at the local level how and why the $32 billion Medicare cuts now under consideration will not only harm seniors' ongoing access to quality nursing home care, but also jeopardize the jobs of the key frontline caregivers who make a significant difference in patients' care outcomes."

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8/12/09 Statement from the American College of Surgeons Regarding Recent Comments from President Obama

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President’s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world.

Web site: www.facs.org
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Sen. Judson Hill (GA): All Health Care Reform is Not Created Equal

With Democratic control of both the White House and Congress, national health care reform has a better chance of passing now than any time in recent history. Americans agree that change in our health care system is necessary. Escalating health care and insurance premiums are unsustainable for most families, businesses and all levels of government. Every day it becomes more and more evident that all health care reform is not created equal.

Conservatives have worked for years to change the fundamentals of health care and health care financing to achieve a patient centered, prevention focused, free market system. Many moderates and liberals want government-based health care reform in which the government provides for everyone and health care is “free.” National leaders are advancing numerous reform proposals. Yes, America needs health care reform, but be careful which version you ask for because as the saying goes, “choose your rut in the road carefully since you’ll be in it for the next 100 miles”.

Political experts today will tell you that some sort of health care reform will pass. Any national health care reform measures that survive the political hurdles necessary to become law will be very difficult to change in the future. You and I have a vested interest in which reform proposal actually becomes law.

Early free market successes have begun in several states. These conservative initiatives offer healthier outcomes, stabilized costs, and tax savings and incentives for individual responsibility. For example, Georgia law now incentivizes people to choose healthy behaviors by actually allowing health insurance companies to partially refund premiums to people who stay healthy. But to date, no insurance company has refunded premiums. It’s time we ask them why not?

Three simple conservative steps would improve health care, lower costs and reduce the number of people without health insurance. First, all insurance should be owned by the individual so your financial security and health care coverage is not at risk just because you left your job and lost your company’s insurance. Second, everyone should be able to pay for health care and health insurance with before tax dollars. And third, we should reward personal responsibility and healthy choices with lower insurance premiums.

Governments can and should transform their health care programs. Taxpayers cannot afford to expand and sustain Medicare and Medicaid programs. Instead millions of dollars can be saved by allowing qualified, lower income earners to use their government health care assistance subsidy as a scholarship to buy private health insurance through their employer. In most cases this is a much less expensive option that provides better and more accessible health care. Under such a plan, physician reimbursements for government programs are higher and state taxpayers would save millions of dollars.

If America chooses a national more socialized plan similar to government plans in Western Europe, there will be a huge price to pay. The consequences of this choice are monumental and long-term. European and Canadian health care is characterized by delayed treatments, rationing of care, exorbitant taxpayer costs and sometimes the loss of life. In these countries people with higher incomes purchase private insurance to get to the” head of the line” for better treatment for themselves and their families. Those who chose to buy private insurance continue to pay much higher taxes for national care to cover everyone else. Europeans and Canadians even come to the U.S. to find better health care with easier access for treatment, and yet our government wants to put forth a similar government plan.

Earlier this year the Obama Administration and the Democrat controlled Congress quickly rushed through billions of government spending in the federal “stimulus” bill. Health care reforms cannot be rushed. Health care delivery and financing is too complex. Although Democrats in Congress may have the votes, now is not the time to “just pass” health care reform legislation and then fill in the blanks later. This is not the time to experiment. The details matter too much because lives are at risk.

As we work toward health care reform, everyone should answer three questions and then call their representatives. “What type of reform do you want - patient centered or government centered?” “Should our government be in the health care business or should we incentivize physician-patient relationships?” And finally, “Which health care reform measure encourages and incentives personal responsibility for your health?” Your answers to these questions are vital because if you think health care is expensive now, just wait until you see the costs when it is “free.”
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Minorities, Low Income Americans More Likely to Be Sick, Less Likely to Get Care

U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius yesterday released a new report on health disparities in America and participated in a White House Health Care Stakeholder Discussion on the importance of reform that reduces disparities that exist in our current health care system. The new report Health Disparities: A Case for Closing the Gap is
available at www.HealthReform.gov.

"Minorities and low income Americans are more likely to be sick and less likely to get the care they need," Secretary Sebelius said. "These disparities have plagued our health system and our country for too long. Now, it's time for Democrats and Republicans to come together to pass
reforms this year that help reduce disparities and give all Americans the care they need and deserve."

A Case for Closing the Gap highlights some of the glaring disparities that exist in the current health system. Under the status quo:

- Forty-eight percent of all African Americans adults suffer from
a chronic disease compared to 39 percent of the general population.
- Eight percent of white Americans develop diabetes while 15
percent of African Americans, 14 percent of Hispanics, and 18 percent of
American Indians develop diabetes.
-Hispanics were one-third less likely to be counseled on obesity
than were whites -- only 44 percent of Hispanics received counseling.
- African Americans are 15 percent more likely to be obese than
whites.

The report also notes that 40 percent of low-income Americans do not have health insurance. About one-third of the uninsured have a chronic disease, and they are six times less likely to receive care for a health problem than the insured. In contrast, only 6 percent of high-income
Americans lack insurance.

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HHS Issues Special Report on Health Reform and Launches New healthreform.gov Web Site

Americans expressed serious concerns regarding health care in a new
report released today by the Department of Health and Human Services.
The report, Americans Speak on Health Reform: Report on Health Care
Community Discussions, summarizes comments from the thousands of
Americans who hosted and participated in Health Care Community
Discussions across the country and highlights the need for immediate
action to reform health care.

The report is available on a new Web site dedicated to health reform:
www.healthreform.gov. Unveiled today, the Web site will allow Americans
to view today's White House Health Forum, share their thoughts about
health reform with the Obama Administration and sign a statement in
support of President Obama's commitment to enacting comprehensive health
reform this year.

"This new Web site, www.healthreform.gov and report ensure that when we
discuss health reform, the American people will have an equal stake in
the health reform efforts," said HHS Spokeswoman Jenny Backus.
"Sky-rocketing health care costs are creating enormous pressure on
families, on businesses and our fiscal future. The Obama Administration
is committed to taking action this year on health reform and is calling
on government, business, health care stakeholders and everyday Americans
to come together to make it happen."

In December, then President-elect Obama called on the American people to
host Health Care Community Discussions to assess the seriousness of the
problems and identify solutions. In the last eight years, health
insurance premiums have grown four times faster than wages and one
million more Americans have lost their health insurance each year.
Health care costs have forced small businesses to close their doors and
compelled corporations to ship jobs overseas.

Over 9,000 people signed up in all 50 states and the District of
Columbia to host a discussion, and thousands more participated in these
gatherings. After each Health Care Community Discussion, guests and
hosts were asked to fill out a Participant Survey and submit a group
report to the Presidential Transition Team's Web site summarizing the
group's concerns and suggestions. Group reports from 3,276 Health Care
Community Discussions as well as Participant Surveys from 30,603
participants were collected, analyzed, and are summarized in the report.

The cost of health care services and health insurance was the top
concern about the health care system for 55 percent of discussion
participants. Participants also cited lack of emphasis on prevention,
pre-existing conditions limiting insurance access, and the quality of
care as key concerns. A qualitative analysis found that the Health Care
Community Discussions focused on concerns about a "broken" health
system, access to health insurance and services, rising premiums and
drug costs, medical mistakes and the system not being "for them."

Health Care Community Discussion group participants agreed on the values
and direction that should guide reform. They called for a system that
is fair, patient-centered and choice-oriented, simple and efficient, and
comprehensive. Participants also offered a wide range of specific
solutions, including making health insurance more accessible through an
insurance "exchange" or a public plan option, creating scorecards on
quality and cost, improving the nutritional content of school lunches,
implementing electronic medical records and creating an AmeriCorps for
health workers.

Today's report also includes a series of personal testimonials from
Health Care Community Discussion participants who expressed their
concern about the state of health care in America. A farmer from Enid,
Okla., explained, "I have spent my life's savings on [health care], and
now I am refused care at our local hospital because I cannot pay. I may
have to file bankruptcy due to this." A report from Missoula, Mont.,
commenting on policies that allow insurers to deny coverage to Americans
with pre-existing conditions said, "No mother should have to say her
daughter is 'uninsurable.'"

President Obama has committed to reforming health care this year and has
already acted to make health care more affordable and accessible.
President Obama signed a law to provide and protect health insurance for
11 million American children through the Children's Health Insurance
Program. The President also signed into law the American Recovery and
Reinvestment Act which includes investments in electronic health
records, prevention, comparative effectiveness research, and health
workforce training -- foundations for a 21st century health care system.
Additionally, the President's Budget Blueprint also includes an historic
commitment to comprehensive health care reform.

A copy of Americans Speak on Health Reform: Report on Health Care
Community Discussions, group reports filed by participants and hundreds
of submitted photos are available at www.HealthReform.gov.

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National Health Care Experts Say, "Time is now" for Health Care Reform

Reforming America¿s health care system requires innovative strategies for disease prevention, primary care and finance and payment, leaders from the health and policymaking communities declared during three days of panel discussions recently held at Emory University.

Participants in the Center for Entitlement Reform's expert panel meetings also agreed that comprehensive health reform encompassing those three key areas is essential to controlling the rise in chronic diseases and stemming the growth in health care spending that threatens to overtop federal budgets.

The meetings convened a bipartisan group of national health leaders and were sponsored by the Emory University Center for Entitlement Reform and the Peter G. Peterson Foundation.

"There is an urgent need to develop effective models of primary care that link up clinicians and community-based prevention," says Kenneth E. Thorpe, PhD, professor and chair of health policy and management at Emory's Rollins School of Public Health, and executive director of the Center for Entitlement Reform.

"America consistently spends more for care than any other industrialized nation, but it's not necessarily the right care," says Thorpe. "Our intent with these meetings is to develop true consensus in health care reform. Across the board, thought leaders agreed that better public and private policies to promote prevention and management of chronic illness, strengthen primary care and modernize finance and payment are needed."

Leaders from some of the most influential organizations in the health care debate assembled at Emory to discuss priorities for health reform in 2009, and how they will lend their efforts to finding consensus recommendations. Janet Collins, PhD, participated in the prevention-focused meeting. She directs the National Center for Chronic Disease Prevention and Promotion at the federal Centers for Disease Control and Prevention (CDC).

"Population-based preventive care is the missing book-end to clinical care, and an important factor in moving the focus of the system to disease prevention and health promotion," says Collins. "In short, real health reform starts with prevention."

Robert Berenson, MD, a senior fellow at the Urban Institute, participated in the panel tackling reforms in care delivery. He outlined recommendations on patient-centered medical homes that he said could facilitate partnerships between individual patients, their personal physicians, and patients¿ families and communities to improve individual health and health system functioning.

According Berenson, 20 percent of the Medicare population suffers from five or more chronic conditions, and at least two thirds of Medicare spending goes toward chronic care.

Chronic diseases increasingly affect younger Americans as well. According to the CDC, chronic disease accounts for about 75 percent of the nation's aggregate health care spending - or about $5,300 per person in the U.S. each year.

"Cost control currently is impossible, but it is absolutely vital," says Henry Aaron, PhD, a senior fellow at the Brookings Institution. Speaking on health care finance and payment, Aaron warns, "Large and growing federal health care spending threatens unsustainable budget deficits, while large and growing private health care spending threatens to crowd out growth of consumption other than on health care." Aaron argues that current payment arrangements should be modified so patients and providers have incentives to economize, and that research should be undertaken so that they have information to do so sensibly.

Peter G. Peterson Foundation Vice President Gene Steuerle notes the importance the Obama Administration and leaders in the 111th Congress have placed on moving forward a comprehensive health reform bill to address prevention, delivery, cost, quality and coverage early in 2009.

"The new Administration has already begun to lay the framework for health care reform legislation," says Steuerle. "I congratulate the Center for Entitlement Reform on assembling this respected group of bipartisan health care leaders and outlining their consensus recommendations. We have a unique opportunity to reform our health care and entitlement programs to reflect current economic realities and longer life spans, while also making the programs solvent, sustainable and more savings-oriented."

Consensus priorities from each of the three expert panel meetings will be compiled by the Center for Entitlement Reform to make policy recommendations that inform and educate business and labor leaders, health services and health care professionals, the media and the public.

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