Monday, May 09, 2005
Experts Poles Apart on How To Reform Troubled System Psychiatric News story - "Market and regulatory reform coupled with tax credits for the uninsured is pitted against a Canadian-style, single-payer national health insurance program. It was the leading physician group advocating for publicly funded national health insurance versus the voice of organized American medicine that has for decades crusaded against "socialized medicine." And their divergent visions for health system reform could not be more starkly at odds: tax credits for the uninsured in a free-market, multipayer system offering a wide range of health plan options tailored to the individual, or a Canadian-style, publicly funded, and government-run single-payer system. Those two visions clashed when psychiatrist Jeremy Lazarus, M.D., speaking for the AMA, countered Steffie Wool-handler, M.D., co-founder of Physicians for a National Health Program, in a debate sponsored by the American Medical Student Association in Washington, D.C., in March. .."
States Propose Sweeping Changes to Trim Medicaid by Billions Lead, front page article in the
New York Times - "Governors and state legislators have devised proposals for sweeping changes in Medicaid to curb its rapid growth and save billions of dollars. Under the proposals, some beneficiaries would have to pay more for care, and states would have more latitude to limit the scope of services. The proposals, drafted by separate working groups of governors and state legislators, provide guidance to Congress, which 10 days ago endorsed a budget blueprint that would cut projected Medicaid spending by $10 billion over the next five years. Many of the proposals resemble ideas advanced by President Bush as part of his 2006 budget. In some cases, the governors embrace Mr. Bush's proposals but go further. At the same time, they also reject some of the president's recommendations that they believe would shift costs to the states." [Viewing
New York Times resources requires registration, which is free]. Abbreviated versions of this story are available at a number of sites that do not require registration, among them
The Argus(California) and Vermont's
Times-Argus. See also
States face "meltdown" over Medicaid (
American Medical News).
Pay-for-Performance Could Better Align Incentives in Behavioral Health Care Drug Benefit Trends story at
Medscape - "The Institute of Medicine's (IOM's) 2001 report, Crossing the Quality Chasm, portrays the quality of health care delivered in the United States as falling far short of established benchmarks. According to the report, "Quality problems are everywhere, affecting many patients. Between the health care we have and the care we could have lies not just a gap, but a chasm." The IOM report attributes many of the problems to fundamental financial misalignments. For example, physicians, who are not payers, and patients, who may be partial payers, drive treatment decisions. The report also cites issues of rapidly changing technology, limited consumer knowledge, and the reluctance of health care organizations to implement improvements that are unaccompanied by adequate financial compensation. It seems that delivering high-quality care in the current US health care system does not always pay. One solution is to promote change with financial incentives to providers and provider organizations. Such a typical American free-enterprise initiative has recently developed and even has a name: pay-for-performance (P4P)." [Viewing
Medscape resources requires registration, which is free].
