HEALTH REFORM: The Neverending Story

In health care, everyone has a story, one that shows how our current system fails us and why the need for reform is so urgent.

There's the worried parent whose grown child doesn't have health insurance, either because they can't afford it or don't think they need it. There's the women whose preventive screening caught a chronic disease early, and whose premiums promptly skyrocketed. And then there's the mother who went to three different hospitals before her daughter was properly diagnosed, only to find that her insurance wouldn't cover treatments the company deemed experimental.

We heard all of these stories and more at health care roundtable this week hosted by Politics Magazine (read some of their coverage of the events here and here).

Our colleague Julie Barnes, deputy director of New America's Health Policy Program. moderated the panel on "the future of healthcare reform and public funding." With Sen. John Barrasso (R-WY), Rep. Michael Burgess (R-TX), former Rep. Martin Frost (D-TX), and former Rep. Nancy Johnson (R-CT).

The majority of the panelists seemed confident some form of health reform would pass. Johnson was 50-50 on whether something would pass, but definite on the need for reform.

As sitting members of the minority party, Burgess and Barrasso were no great proponents of the Democratic plans being debated. There are plenty of things they'd change, particularly on medical malpractice reform (both are doctors). But they did note that on insurance market reform, including ending the practices of rescissions and exclusions based on preexisting conditions, there was a great deal of bipartisan agreement. As Frost noted, even though his Republican colleagues might not be able to vote for a final bill there was a great deal they could do to help shape the process and improve the final outcome. Johnson emphasized that one of the biggest challenges for reform was figuring out a way to realign incentives to control costs.

"You can't do the future just like we did the past because that's what got us here," Johnson said.

All of the panelist agreed on the need to pay for reform in a way that did not add to the deficit -- something the latest CBO score of the Baucus bill should help them feel a little better about.

The second panel focused on the implications of health reform, for individuals and industries, as well as politicians.

Harvard economist Michael Chernew, moderated the panel, which featured former Vermont Gov. Howard Dean, MD, Christopher Badgley, of PhRMA, Carol Kelly, from the National Association of Chain Drug Stores, and John Rother, AARP.

Dean stressed the need to move away from fee-for-service Medicine and gave a robust defense of the public plan but thought that the level-playing field compromises of Sen. Schumer could pass Congress.

Kelly talked about the challenges of medication management and the need to coordinate care across the all sectors of the health care delivery system.

Badgley felt proposals for comparative effectiveness research could be a boon for the members of his organization rewarding "true innovation" while limiting incremental changes that don't add value for consumers.

Rother talked about the tough choices policy makers will have to face, emphasizing the outstanding issues on financing, changing the delivery system, and short term vs. long term political calculations. As for the fate of reform, he noted that "once you get people actually insured, all the myths go away."